Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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	$2.63
Max. Negotiated Rate	$3.75
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna New Business (MI Preferred)	$2.71
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: 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

METHACHOLINE 0.0625 MG/ML (VIAL E) SOLUTION FOR INHALATION

Facility

$170.20

Service Code	HCPCS J7674
Hospital Charge Code	180308
Hospital Revenue Code	636
Min. Negotiated Rate	$107.23
Max. Negotiated Rate	$153.18
Rate for Payer: Aetna Commercial	$144.67
Rate for Payer: Aetna New Business (MI Preferred)	$110.63
Rate for Payer: Cash Price	$136.16
Rate for Payer: Cofinity Advantage	$119.14
Rate for Payer: Cofinity Commercial	$146.37
Rate for Payer: Encore Health Key Benefits Commercial	$136.16
Rate for Payer: Healthscope Commercial	$153.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$144.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$127.65
Rate for Payer: PHP Commercial	$144.67
Rate for Payer: Priority Health SBD	$107.23

METHACHOLINE 0.0625 MG/ML (VIAL E) SOLUTION FOR INHALATION

Facility

$170.20

Service Code	HCPCS J7674
Hospital Charge Code	180308
Hospital Revenue Code	636
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$153.18
Rate for Payer: Aetna Commercial	$144.67
Rate for Payer: Aetna Medicare	$85.10
Rate for Payer: Aetna New Business (MI Preferred)	$110.63
Rate for Payer: BCBS Complete	$68.08
Rate for Payer: BCBS Trust/PPO	$4.75
Rate for Payer: BCN Commercial	$4.75
Rate for Payer: Cash Price	$136.16
Rate for Payer: Cash Price	$136.16
Rate for Payer: Cofinity Advantage	$119.14
Rate for Payer: Cofinity Commercial	$146.37
Rate for Payer: Encore Health Key Benefits Commercial	$136.16
Rate for Payer: Healthscope Commercial	$153.18
Rate for Payer: MI Amish Medical Board Commercial	$136.16
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$144.67
Rate for Payer: Opus (Opus Packaging Group) HMA	$127.65
Rate for Payer: PHP Commercial	$144.67
Rate for Payer: Priority Health SBD	$107.23
Rate for Payer: UHC All Payor (Choice/PPO)	$3.14
Rate for Payer: UHC Core	$3.14
Rate for Payer: UHC Exchange	$3.14

METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION

Facility

$313.14

Service Code	HCPCS J7674
Hospital Charge Code	27032
Hospital Revenue Code	636
Min. Negotiated Rate	$197.28
Max. Negotiated Rate	$281.83
Rate for Payer: Aetna Commercial	$266.17
Rate for Payer: Aetna New Business (MI Preferred)	$203.54
Rate for Payer: Cash Price	$250.51
Rate for Payer: Cofinity Advantage	$219.20
Rate for Payer: Cofinity Commercial	$269.30
Rate for Payer: Encore Health Key Benefits Commercial	$250.51
Rate for Payer: Healthscope Commercial	$281.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$266.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$234.85
Rate for Payer: PHP Commercial	$266.17
Rate for Payer: Priority Health SBD	$197.28

METHACHOLINE CHLORIDE 100 MG SOLUTION FOR INHALATION

Facility

$313.14

Service Code	HCPCS J7674
Hospital Charge Code	27032
Hospital Revenue Code	636
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$281.83
Rate for Payer: Aetna Commercial	$266.17
Rate for Payer: Aetna Medicare	$156.57
Rate for Payer: Aetna New Business (MI Preferred)	$203.54
Rate for Payer: BCBS Complete	$125.26
Rate for Payer: BCBS Trust/PPO	$4.75
Rate for Payer: BCN Commercial	$4.75
Rate for Payer: Cash Price	$250.51
Rate for Payer: Cash Price	$250.51
Rate for Payer: Cofinity Advantage	$219.20
Rate for Payer: Cofinity Commercial	$269.30
Rate for Payer: Encore Health Key Benefits Commercial	$250.51
Rate for Payer: Healthscope Commercial	$281.83
Rate for Payer: MI Amish Medical Board Commercial	$250.51
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$266.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$234.85
Rate for Payer: PHP Commercial	$266.17
Rate for Payer: Priority Health SBD	$197.28
Rate for Payer: UHC All Payor (Choice/PPO)	$3.14
Rate for Payer: UHC Core	$3.14
Rate for Payer: UHC Exchange	$3.14

METHADONE 10 MG/ML ORAL CONCENTRATE

Facility

$132.09

Service Code	NDC 00054355344
Hospital Charge Code	15996
Hospital Revenue Code	637
Min. Negotiated Rate	$51.91
Max. Negotiated Rate	$118.88
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna Medicare	$66.05
Rate for Payer: Aetna New Business (MI Preferred)	$85.86
Rate for Payer: BCBS Complete	$52.84
Rate for Payer: Cash Price	$105.67
Rate for Payer: Cofinity Advantage	$92.46
Rate for Payer: Cofinity Commercial	$113.60
Rate for Payer: Encore Health Key Benefits Commercial	$105.67
Rate for Payer: Healthscope Commercial	$118.88
Rate for Payer: MI Amish Medical Board Commercial	$105.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.07
Rate for Payer: PHP Commercial	$112.28
Rate for Payer: Priority Health SBD	$83.22
Rate for Payer: UHC All Payor (Choice/PPO)	$85.86
Rate for Payer: UHC Core	$68.82
Rate for Payer: UHC Exchange	$51.91

METHADONE 10 MG/ML ORAL CONCENTRATE

Facility

$132.09

Service Code	NDC 00054355344
Hospital Charge Code	15996
Hospital Revenue Code	637
Min. Negotiated Rate	$83.22
Max. Negotiated Rate	$118.88
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna New Business (MI Preferred)	$85.86
Rate for Payer: Cash Price	$105.67
Rate for Payer: Cofinity Advantage	$92.46
Rate for Payer: Cofinity Commercial	$113.60
Rate for Payer: Encore Health Key Benefits Commercial	$105.67
Rate for Payer: Healthscope Commercial	$118.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$112.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$99.07
Rate for Payer: PHP Commercial	$112.28
Rate for Payer: Priority Health SBD	$83.22

METHADONE 10 MG TABLET

Facility

$577.50

Service Code	NDC 00406577162
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$363.82
Max. Negotiated Rate	$519.75
Rate for Payer: Aetna Commercial	$490.88
Rate for Payer: Aetna New Business (MI Preferred)	$375.38
Rate for Payer: Cash Price	$462.00
Rate for Payer: Cofinity Advantage	$404.25
Rate for Payer: Cofinity Commercial	$496.65
Rate for Payer: Encore Health Key Benefits Commercial	$462.00
Rate for Payer: Healthscope Commercial	$519.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$490.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$433.12
Rate for Payer: PHP Commercial	$490.88
Rate for Payer: Priority Health SBD	$363.82

METHADONE 10 MG TABLET

Facility

$577.50

Service Code	NDC 00406577162
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$226.96
Max. Negotiated Rate	$519.75
Rate for Payer: Aetna Commercial	$490.88
Rate for Payer: Aetna Medicare	$288.75
Rate for Payer: Aetna New Business (MI Preferred)	$375.38
Rate for Payer: BCBS Complete	$231.00
Rate for Payer: Cash Price	$462.00
Rate for Payer: Cofinity Advantage	$404.25
Rate for Payer: Cofinity Commercial	$496.65
Rate for Payer: Encore Health Key Benefits Commercial	$462.00
Rate for Payer: Healthscope Commercial	$519.75
Rate for Payer: MI Amish Medical Board Commercial	$462.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$490.88
Rate for Payer: Opus (Opus Packaging Group) HMA	$433.12
Rate for Payer: PHP Commercial	$490.88
Rate for Payer: Priority Health SBD	$363.82
Rate for Payer: UHC All Payor (Choice/PPO)	$375.38
Rate for Payer: UHC Core	$300.88
Rate for Payer: UHC Exchange	$226.96

METHADONE 10 MG TABLET

Facility

$5.78

Service Code	NDC 00406577123
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$5.20
Rate for Payer: Aetna Commercial	$4.91
Rate for Payer: Aetna Medicare	$2.89
Rate for Payer: Aetna New Business (MI Preferred)	$3.76
Rate for Payer: BCBS Complete	$2.31
Rate for Payer: Cash Price	$4.62
Rate for Payer: Cofinity Advantage	$4.05
Rate for Payer: Cofinity Commercial	$4.97
Rate for Payer: Encore Health Key Benefits Commercial	$4.62
Rate for Payer: Healthscope Commercial	$5.20
Rate for Payer: MI Amish Medical Board Commercial	$4.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.33
Rate for Payer: PHP Commercial	$4.91
Rate for Payer: Priority Health SBD	$3.64
Rate for Payer: UHC All Payor (Choice/PPO)	$3.76
Rate for Payer: UHC Core	$3.01
Rate for Payer: UHC Exchange	$2.27

METHADONE 10 MG TABLET

Facility

$5.78

Service Code	NDC 00406577123
Hospital Charge Code	4953
Hospital Revenue Code	637
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$5.20
Rate for Payer: Aetna Commercial	$4.91
Rate for Payer: Aetna New Business (MI Preferred)	$3.76
Rate for Payer: Cash Price	$4.62
Rate for Payer: Cofinity Advantage	$4.05
Rate for Payer: Cofinity Commercial	$4.97
Rate for Payer: Encore Health Key Benefits Commercial	$4.62
Rate for Payer: Healthscope Commercial	$5.20
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.91
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.33
Rate for Payer: PHP Commercial	$4.91
Rate for Payer: Priority Health SBD	$3.64

METHADONE 5 MG TABLET

Facility

$6.08

Service Code	NDC 00406575523
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$5.47
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna Medicare	$3.04
Rate for Payer: Aetna New Business (MI Preferred)	$3.95
Rate for Payer: BCBS Complete	$2.43
Rate for Payer: Cash Price	$4.86
Rate for Payer: Cofinity Advantage	$4.26
Rate for Payer: Cofinity Commercial	$5.23
Rate for Payer: Encore Health Key Benefits Commercial	$4.86
Rate for Payer: Healthscope Commercial	$5.47
Rate for Payer: MI Amish Medical Board Commercial	$4.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.56
Rate for Payer: PHP Commercial	$5.17
Rate for Payer: Priority Health SBD	$3.83
Rate for Payer: UHC All Payor (Choice/PPO)	$3.95
Rate for Payer: UHC Core	$3.17
Rate for Payer: UHC Exchange	$2.39

METHADONE 5 MG TABLET

Facility

$6.08

Service Code	NDC 00406575523
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$3.83
Max. Negotiated Rate	$5.47
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna New Business (MI Preferred)	$3.95
Rate for Payer: Cash Price	$4.86
Rate for Payer: Cofinity Advantage	$4.26
Rate for Payer: Cofinity Commercial	$5.23
Rate for Payer: Encore Health Key Benefits Commercial	$4.86
Rate for Payer: Healthscope Commercial	$5.47
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.17
Rate for Payer: Opus (Opus Packaging Group) HMA	$4.56
Rate for Payer: PHP Commercial	$5.17
Rate for Payer: Priority Health SBD	$3.83

METHADONE 5 MG TABLET

Facility

$607.25

Service Code	NDC 00406575562
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$238.65
Max. Negotiated Rate	$546.52
Rate for Payer: Aetna Commercial	$516.16
Rate for Payer: Aetna Medicare	$303.62
Rate for Payer: Aetna New Business (MI Preferred)	$394.71
Rate for Payer: BCBS Complete	$242.90
Rate for Payer: Cash Price	$485.80
Rate for Payer: Cofinity Advantage	$425.07
Rate for Payer: Cofinity Commercial	$522.24
Rate for Payer: Encore Health Key Benefits Commercial	$485.80
Rate for Payer: Healthscope Commercial	$546.52
Rate for Payer: MI Amish Medical Board Commercial	$485.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$516.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$455.44
Rate for Payer: PHP Commercial	$516.16
Rate for Payer: Priority Health SBD	$382.57
Rate for Payer: UHC All Payor (Choice/PPO)	$394.71
Rate for Payer: UHC Core	$316.38
Rate for Payer: UHC Exchange	$238.65

METHADONE 5 MG TABLET

Facility

$607.25

Service Code	NDC 00406575562
Hospital Charge Code	4954
Hospital Revenue Code	637
Min. Negotiated Rate	$382.57
Max. Negotiated Rate	$546.52
Rate for Payer: Aetna Commercial	$516.16
Rate for Payer: Aetna New Business (MI Preferred)	$394.71
Rate for Payer: Cash Price	$485.80
Rate for Payer: Cofinity Advantage	$425.07
Rate for Payer: Cofinity Commercial	$522.24
Rate for Payer: Encore Health Key Benefits Commercial	$485.80
Rate for Payer: Healthscope Commercial	$546.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$516.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$455.44
Rate for Payer: PHP Commercial	$516.16
Rate for Payer: Priority Health SBD	$382.57

METHENAMINE HIPPURATE 1 GRAM TABLET

Facility

$7.88

Service Code	NDC 60687069411
Hospital Charge Code	10549
Hospital Revenue Code	637
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$7.09
Rate for Payer: Aetna Commercial	$6.70
Rate for Payer: Aetna Medicare	$3.94
Rate for Payer: Aetna New Business (MI Preferred)	$5.12
Rate for Payer: BCBS Complete	$3.15
Rate for Payer: Cash Price	$6.30
Rate for Payer: Cofinity Advantage	$5.52
Rate for Payer: Cofinity Commercial	$6.78
Rate for Payer: Encore Health Key Benefits Commercial	$6.30
Rate for Payer: Healthscope Commercial	$7.09
Rate for Payer: MI Amish Medical Board Commercial	$6.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.91
Rate for Payer: PHP Commercial	$6.70
Rate for Payer: Priority Health SBD	$4.96
Rate for Payer: UHC All Payor (Choice/PPO)	$5.12
Rate for Payer: UHC Core	$4.11
Rate for Payer: UHC Exchange	$3.10

METHENAMINE HIPPURATE 1 GRAM TABLET

Facility

$236.21

Service Code	NDC 60687069421
Hospital Charge Code	10549
Hospital Revenue Code	637
Min. Negotiated Rate	$148.81
Max. Negotiated Rate	$212.59
Rate for Payer: Aetna Commercial	$200.78
Rate for Payer: Aetna New Business (MI Preferred)	$153.54
Rate for Payer: Cash Price	$188.97
Rate for Payer: Cofinity Advantage	$165.35
Rate for Payer: Cofinity Commercial	$203.14
Rate for Payer: Encore Health Key Benefits Commercial	$188.97
Rate for Payer: Healthscope Commercial	$212.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$200.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$177.16
Rate for Payer: PHP Commercial	$200.78
Rate for Payer: Priority Health SBD	$148.81

METHENAMINE HIPPURATE 1 GRAM TABLET

Facility

$236.21

Service Code	NDC 60687069421
Hospital Charge Code	10549
Hospital Revenue Code	637
Min. Negotiated Rate	$92.83
Max. Negotiated Rate	$212.59
Rate for Payer: Aetna Commercial	$200.78
Rate for Payer: Aetna Medicare	$118.11
Rate for Payer: Aetna New Business (MI Preferred)	$153.54
Rate for Payer: BCBS Complete	$94.48
Rate for Payer: Cash Price	$188.97
Rate for Payer: Cofinity Advantage	$165.35
Rate for Payer: Cofinity Commercial	$203.14
Rate for Payer: Encore Health Key Benefits Commercial	$188.97
Rate for Payer: Healthscope Commercial	$212.59
Rate for Payer: MI Amish Medical Board Commercial	$188.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$200.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$177.16
Rate for Payer: PHP Commercial	$200.78
Rate for Payer: Priority Health SBD	$148.81
Rate for Payer: UHC All Payor (Choice/PPO)	$153.54
Rate for Payer: UHC Core	$123.07
Rate for Payer: UHC Exchange	$92.83

METHENAMINE HIPPURATE 1 GRAM TABLET

Facility

$7.88

Service Code	NDC 60687069411
Hospital Charge Code	10549
Hospital Revenue Code	637
Min. Negotiated Rate	$4.96
Max. Negotiated Rate	$7.09
Rate for Payer: Aetna Commercial	$6.70
Rate for Payer: Aetna New Business (MI Preferred)	$5.12
Rate for Payer: Cash Price	$6.30
Rate for Payer: Cofinity Advantage	$5.52
Rate for Payer: Cofinity Commercial	$6.78
Rate for Payer: Encore Health Key Benefits Commercial	$6.30
Rate for Payer: Healthscope Commercial	$7.09
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.91
Rate for Payer: PHP Commercial	$6.70
Rate for Payer: Priority Health SBD	$4.96

METHIMAZOLE 10 MG TABLET

Facility

$303.15

Service Code	NDC 23155007101
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$119.14
Max. Negotiated Rate	$272.83
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna Medicare	$151.57
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: BCBS Complete	$121.26
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Advantage	$212.21
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.83
Rate for Payer: MI Amish Medical Board Commercial	$242.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$227.36
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health SBD	$190.98
Rate for Payer: UHC All Payor (Choice/PPO)	$197.05
Rate for Payer: UHC Core	$157.94
Rate for Payer: UHC Exchange	$119.14

METHIMAZOLE 10 MG TABLET

Facility

$4.01

Service Code	NDC 60687068011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$3.61
Rate for Payer: Aetna Commercial	$3.41
Rate for Payer: Aetna New Business (MI Preferred)	$2.61
Rate for Payer: Cash Price	$3.21
Rate for Payer: Cofinity Advantage	$2.81
Rate for Payer: Cofinity Commercial	$3.45
Rate for Payer: Encore Health Key Benefits Commercial	$3.21
Rate for Payer: Healthscope Commercial	$3.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.01
Rate for Payer: PHP Commercial	$3.41
Rate for Payer: Priority Health SBD	$2.53

METHIMAZOLE 10 MG TABLET

Facility

$303.15

Service Code	NDC 23155007101
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$190.98
Max. Negotiated Rate	$272.83
Rate for Payer: Aetna Commercial	$257.68
Rate for Payer: Aetna New Business (MI Preferred)	$197.05
Rate for Payer: Cash Price	$242.52
Rate for Payer: Cofinity Advantage	$212.21
Rate for Payer: Cofinity Commercial	$260.71
Rate for Payer: Encore Health Key Benefits Commercial	$242.52
Rate for Payer: Healthscope Commercial	$272.83
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$257.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$227.36
Rate for Payer: PHP Commercial	$257.68
Rate for Payer: Priority Health SBD	$190.98

METHIMAZOLE 10 MG TABLET

Facility

$4.01

Service Code	NDC 60687068011
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$3.61
Rate for Payer: Aetna Commercial	$3.41
Rate for Payer: Aetna Medicare	$2.00
Rate for Payer: Aetna New Business (MI Preferred)	$2.61
Rate for Payer: BCBS Complete	$1.60
Rate for Payer: Cash Price	$3.21
Rate for Payer: Cofinity Advantage	$2.81
Rate for Payer: Cofinity Commercial	$3.45
Rate for Payer: Encore Health Key Benefits Commercial	$3.21
Rate for Payer: Healthscope Commercial	$3.61
Rate for Payer: MI Amish Medical Board Commercial	$3.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.41
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.01
Rate for Payer: PHP Commercial	$3.41
Rate for Payer: Priority Health SBD	$2.53
Rate for Payer: UHC All Payor (Choice/PPO)	$2.61
Rate for Payer: UHC Core	$2.09
Rate for Payer: UHC Exchange	$1.58

METHIMAZOLE 10 MG TABLET

Facility

$400.80

Service Code	NDC 60687068001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$252.50
Max. Negotiated Rate	$360.72
Rate for Payer: Aetna Commercial	$340.68
Rate for Payer: Aetna New Business (MI Preferred)	$260.52
Rate for Payer: Cash Price	$320.64
Rate for Payer: Cofinity Advantage	$280.56
Rate for Payer: Cofinity Commercial	$344.69
Rate for Payer: Encore Health Key Benefits Commercial	$320.64
Rate for Payer: Healthscope Commercial	$360.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$340.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$300.60
Rate for Payer: PHP Commercial	$340.68
Rate for Payer: Priority Health SBD	$252.50

METHIMAZOLE 10 MG TABLET

Facility

$400.80

Service Code	NDC 60687068001
Hospital Charge Code	10552
Hospital Revenue Code	637
Min. Negotiated Rate	$157.51
Max. Negotiated Rate	$360.72
Rate for Payer: Aetna Commercial	$340.68
Rate for Payer: Aetna Medicare	$200.40
Rate for Payer: Aetna New Business (MI Preferred)	$260.52
Rate for Payer: BCBS Complete	$160.32
Rate for Payer: Cash Price	$320.64
Rate for Payer: Cofinity Advantage	$280.56
Rate for Payer: Cofinity Commercial	$344.69
Rate for Payer: Encore Health Key Benefits Commercial	$320.64
Rate for Payer: Healthscope Commercial	$360.72
Rate for Payer: MI Amish Medical Board Commercial	$320.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$340.68
Rate for Payer: Opus (Opus Packaging Group) HMA	$300.60
Rate for Payer: PHP Commercial	$340.68
Rate for Payer: Priority Health SBD	$252.50
Rate for Payer: UHC All Payor (Choice/PPO)	$260.52
Rate for Payer: UHC Core	$208.82
Rate for Payer: UHC Exchange	$157.51

Know your out-of-pocket cost for care.

All Charges