Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

CENOBAMATE 50 MG TABLET

Facility

$4,182.15

Service Code	NDC 71699005030
Hospital Charge Code	192888
Hospital Revenue Code	637
Min. Negotiated Rate	$2,634.75
Max. Negotiated Rate	$3,763.93
Rate for Payer: Aetna Commercial	$3,554.83
Rate for Payer: Aetna New Business (MI Preferred)	$2,718.40
Rate for Payer: Cash Price	$3,345.72
Rate for Payer: Cofinity Advantage	$2,927.51
Rate for Payer: Cofinity Commercial	$3,596.65
Rate for Payer: Encore Health Key Benefits Commercial	$3,345.72
Rate for Payer: Healthscope Commercial	$3,763.93
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,554.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,136.61
Rate for Payer: PHP Commercial	$3,554.83
Rate for Payer: Priority Health SBD	$2,634.75

CENOBAMATE 50 MG TABLET

Facility

$4,182.15

Service Code	NDC 71699005030
Hospital Charge Code	192888
Hospital Revenue Code	637
Min. Negotiated Rate	$1,643.58
Max. Negotiated Rate	$3,763.93
Rate for Payer: Aetna Commercial	$3,554.83
Rate for Payer: Aetna Medicare	$2,091.07
Rate for Payer: Aetna New Business (MI Preferred)	$2,718.40
Rate for Payer: BCBS Complete	$1,672.86
Rate for Payer: Cash Price	$3,345.72
Rate for Payer: Cofinity Advantage	$2,927.51
Rate for Payer: Cofinity Commercial	$3,596.65
Rate for Payer: Encore Health Key Benefits Commercial	$3,345.72
Rate for Payer: Healthscope Commercial	$3,763.93
Rate for Payer: MI Amish Medical Board Commercial	$3,345.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,554.83
Rate for Payer: Opus (Opus Packaging Group) HMA	$3,136.61
Rate for Payer: PHP Commercial	$3,554.83
Rate for Payer: Priority Health SBD	$2,634.75
Rate for Payer: UHC All Payor (Choice/PPO)	$2,718.40
Rate for Payer: UHC Core	$2,178.90
Rate for Payer: UHC Exchange	$1,643.58

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$203.30

Service Code	NDC 00093417773
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$128.08
Max. Negotiated Rate	$182.97
Rate for Payer: Aetna Commercial	$172.81
Rate for Payer: Aetna New Business (MI Preferred)	$132.15
Rate for Payer: Cash Price	$162.64
Rate for Payer: Cofinity Advantage	$142.31
Rate for Payer: Cofinity Commercial	$174.84
Rate for Payer: Encore Health Key Benefits Commercial	$162.64
Rate for Payer: Healthscope Commercial	$182.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$172.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$152.47
Rate for Payer: PHP Commercial	$172.81
Rate for Payer: Priority Health SBD	$128.08

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$282.00

Service Code	NDC 67877054588
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$110.83
Max. Negotiated Rate	$253.80
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna Medicare	$141.00
Rate for Payer: Aetna New Business (MI Preferred)	$183.30
Rate for Payer: BCBS Complete	$112.80
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cofinity Advantage	$197.40
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Encore Health Key Benefits Commercial	$225.60
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: MI Amish Medical Board Commercial	$225.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$239.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$211.50
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health SBD	$177.66
Rate for Payer: UHC All Payor (Choice/PPO)	$183.30
Rate for Payer: UHC Core	$146.92
Rate for Payer: UHC Exchange	$110.83

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$203.30

Service Code	NDC 00093417773
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$79.90
Max. Negotiated Rate	$182.97
Rate for Payer: Aetna Commercial	$172.81
Rate for Payer: Aetna Medicare	$101.65
Rate for Payer: Aetna New Business (MI Preferred)	$132.15
Rate for Payer: BCBS Complete	$81.32
Rate for Payer: Cash Price	$162.64
Rate for Payer: Cofinity Advantage	$142.31
Rate for Payer: Cofinity Commercial	$174.84
Rate for Payer: Encore Health Key Benefits Commercial	$162.64
Rate for Payer: Healthscope Commercial	$182.97
Rate for Payer: MI Amish Medical Board Commercial	$162.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$172.81
Rate for Payer: Opus (Opus Packaging Group) HMA	$152.47
Rate for Payer: PHP Commercial	$172.81
Rate for Payer: Priority Health SBD	$128.08
Rate for Payer: UHC All Payor (Choice/PPO)	$132.15
Rate for Payer: UHC Core	$105.92
Rate for Payer: UHC Exchange	$79.90

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$354.85

Service Code	NDC 68180044101
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$223.56
Max. Negotiated Rate	$319.37
Rate for Payer: Aetna Commercial	$301.62
Rate for Payer: Aetna New Business (MI Preferred)	$230.65
Rate for Payer: Cash Price	$283.88
Rate for Payer: Cofinity Advantage	$248.40
Rate for Payer: Cofinity Commercial	$305.17
Rate for Payer: Encore Health Key Benefits Commercial	$283.88
Rate for Payer: Healthscope Commercial	$319.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$301.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$266.14
Rate for Payer: PHP Commercial	$301.62
Rate for Payer: Priority Health SBD	$223.56

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$354.85

Service Code	NDC 68180044101
Hospital Charge Code	9502
Hospital Revenue Code	637
Min. Negotiated Rate	$139.46
Max. Negotiated Rate	$319.37
Rate for Payer: Aetna Commercial	$301.62
Rate for Payer: Aetna Medicare	$177.43
Rate for Payer: Aetna New Business (MI Preferred)	$230.65
Rate for Payer: BCBS Complete	$141.94
Rate for Payer: Cash Price	$283.88
Rate for Payer: Cofinity Advantage	$248.40
Rate for Payer: Cofinity Commercial	$305.17
Rate for Payer: Encore Health Key Benefits Commercial	$283.88
Rate for Payer: Healthscope Commercial	$319.37
Rate for Payer: MI Amish Medical Board Commercial	$283.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$301.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$266.14
Rate for Payer: PHP Commercial	$301.62
Rate for Payer: Priority Health SBD	$223.56
Rate for Payer: UHC All Payor (Choice/PPO)	$230.65
Rate for Payer: UHC Core	$184.88
Rate for Payer: UHC Exchange	$139.46

CEPHALEXIN 250 MG/5 ML ORAL SUSPENSION

Facility

$282.00

Service Code	NDC 67877054588
Hospital Charge Code	9502
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 Advantage	$197.40
Rate for Payer: Cofinity Commercial	$242.52
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: Opus (Opus Packaging Group) HMA	$211.50
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health SBD	$177.66

CEPHALEXIN 250 MG CAPSULE

Facility

$286.90

Service Code	NDC 60687015201
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$112.75
Max. Negotiated Rate	$258.21
Rate for Payer: Aetna Commercial	$243.87
Rate for Payer: Aetna Medicare	$143.45
Rate for Payer: Aetna New Business (MI Preferred)	$186.49
Rate for Payer: BCBS Complete	$114.76
Rate for Payer: Cash Price	$229.52
Rate for Payer: Cofinity Advantage	$200.83
Rate for Payer: Cofinity Commercial	$246.73
Rate for Payer: Encore Health Key Benefits Commercial	$229.52
Rate for Payer: Healthscope Commercial	$258.21
Rate for Payer: MI Amish Medical Board Commercial	$229.52
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$215.18
Rate for Payer: PHP Commercial	$243.87
Rate for Payer: Priority Health SBD	$180.75
Rate for Payer: UHC All Payor (Choice/PPO)	$186.49
Rate for Payer: UHC Core	$149.47
Rate for Payer: UHC Exchange	$112.75

CEPHALEXIN 250 MG CAPSULE

Facility

$262.20

Service Code	NDC 00904733661
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$103.04
Max. Negotiated Rate	$235.98
Rate for Payer: Aetna Commercial	$222.87
Rate for Payer: Aetna Medicare	$131.10
Rate for Payer: Aetna New Business (MI Preferred)	$170.43
Rate for Payer: BCBS Complete	$104.88
Rate for Payer: Cash Price	$209.76
Rate for Payer: Cofinity Advantage	$183.54
Rate for Payer: Cofinity Commercial	$225.49
Rate for Payer: Encore Health Key Benefits Commercial	$209.76
Rate for Payer: Healthscope Commercial	$235.98
Rate for Payer: MI Amish Medical Board Commercial	$209.76
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$222.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$196.65
Rate for Payer: PHP Commercial	$222.87
Rate for Payer: Priority Health SBD	$165.19
Rate for Payer: UHC All Payor (Choice/PPO)	$170.43
Rate for Payer: UHC Core	$136.61
Rate for Payer: UHC Exchange	$103.04

CEPHALEXIN 250 MG CAPSULE

Facility

$262.20

Service Code	NDC 00904733661
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$165.19
Max. Negotiated Rate	$235.98
Rate for Payer: Aetna Commercial	$222.87
Rate for Payer: Aetna New Business (MI Preferred)	$170.43
Rate for Payer: Cash Price	$209.76
Rate for Payer: Cofinity Advantage	$183.54
Rate for Payer: Cofinity Commercial	$225.49
Rate for Payer: Encore Health Key Benefits Commercial	$209.76
Rate for Payer: Healthscope Commercial	$235.98
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$222.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$196.65
Rate for Payer: PHP Commercial	$222.87
Rate for Payer: Priority Health SBD	$165.19

CEPHALEXIN 250 MG CAPSULE

Facility

$289.05

Service Code	NDC 00093314501
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$182.10
Max. Negotiated Rate	$260.14
Rate for Payer: Aetna Commercial	$245.69
Rate for Payer: Aetna New Business (MI Preferred)	$187.88
Rate for Payer: Cash Price	$231.24
Rate for Payer: Cofinity Advantage	$202.34
Rate for Payer: Cofinity Commercial	$248.58
Rate for Payer: Encore Health Key Benefits Commercial	$231.24
Rate for Payer: Healthscope Commercial	$260.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$245.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$216.79
Rate for Payer: PHP Commercial	$245.69
Rate for Payer: Priority Health SBD	$182.10

CEPHALEXIN 250 MG CAPSULE

Facility

$286.90

Service Code	NDC 60687015201
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$180.75
Max. Negotiated Rate	$258.21
Rate for Payer: Aetna Commercial	$243.87
Rate for Payer: Aetna New Business (MI Preferred)	$186.49
Rate for Payer: Cash Price	$229.52
Rate for Payer: Cofinity Advantage	$200.83
Rate for Payer: Cofinity Commercial	$246.73
Rate for Payer: Encore Health Key Benefits Commercial	$229.52
Rate for Payer: Healthscope Commercial	$258.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$243.87
Rate for Payer: Opus (Opus Packaging Group) HMA	$215.18
Rate for Payer: PHP Commercial	$243.87
Rate for Payer: Priority Health SBD	$180.75

CEPHALEXIN 250 MG CAPSULE

Facility

$289.05

Service Code	NDC 00093314501
Hospital Charge Code	9499
Hospital Revenue Code	637
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$260.14
Rate for Payer: Aetna Commercial	$245.69
Rate for Payer: Aetna Medicare	$144.53
Rate for Payer: Aetna New Business (MI Preferred)	$187.88
Rate for Payer: BCBS Complete	$115.62
Rate for Payer: Cash Price	$231.24
Rate for Payer: Cofinity Advantage	$202.34
Rate for Payer: Cofinity Commercial	$248.58
Rate for Payer: Encore Health Key Benefits Commercial	$231.24
Rate for Payer: Healthscope Commercial	$260.14
Rate for Payer: MI Amish Medical Board Commercial	$231.24
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$245.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$216.79
Rate for Payer: PHP Commercial	$245.69
Rate for Payer: Priority Health SBD	$182.10
Rate for Payer: UHC All Payor (Choice/PPO)	$187.88
Rate for Payer: UHC Core	$150.60
Rate for Payer: UHC Exchange	$113.60

CEPHALEXIN 500 MG CAPSULE

Facility

$3.69

Service Code	NDC 60687016311
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$3.32
Rate for Payer: Aetna Commercial	$3.14
Rate for Payer: Aetna Medicare	$1.84
Rate for Payer: Aetna New Business (MI Preferred)	$2.40
Rate for Payer: BCBS Complete	$1.48
Rate for Payer: Cash Price	$2.95
Rate for Payer: Cofinity Advantage	$2.58
Rate for Payer: Cofinity Commercial	$3.17
Rate for Payer: Encore Health Key Benefits Commercial	$2.95
Rate for Payer: Healthscope Commercial	$3.32
Rate for Payer: MI Amish Medical Board Commercial	$2.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.77
Rate for Payer: PHP Commercial	$3.14
Rate for Payer: Priority Health SBD	$2.32
Rate for Payer: UHC All Payor (Choice/PPO)	$2.40
Rate for Payer: UHC Core	$1.92
Rate for Payer: UHC Exchange	$1.45

CEPHALEXIN 500 MG CAPSULE

Facility

$2.59

Service Code	NDC 50268015211
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$2.33
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna Medicare	$1.29
Rate for Payer: Aetna New Business (MI Preferred)	$1.68
Rate for Payer: BCBS Complete	$1.04
Rate for Payer: Cash Price	$2.07
Rate for Payer: Cofinity Advantage	$1.81
Rate for Payer: Cofinity Commercial	$2.23
Rate for Payer: Encore Health Key Benefits Commercial	$2.07
Rate for Payer: Healthscope Commercial	$2.33
Rate for Payer: MI Amish Medical Board Commercial	$2.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.94
Rate for Payer: PHP Commercial	$2.20
Rate for Payer: Priority Health SBD	$1.63
Rate for Payer: UHC All Payor (Choice/PPO)	$1.68
Rate for Payer: UHC Core	$1.35
Rate for Payer: UHC Exchange	$1.02

CEPHALEXIN 500 MG CAPSULE

Facility

$336.05

Service Code	NDC 67877021901
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$132.07
Max. Negotiated Rate	$302.44
Rate for Payer: Aetna Commercial	$285.64
Rate for Payer: Aetna Medicare	$168.03
Rate for Payer: Aetna New Business (MI Preferred)	$218.43
Rate for Payer: BCBS Complete	$134.42
Rate for Payer: Cash Price	$268.84
Rate for Payer: Cofinity Advantage	$235.24
Rate for Payer: Cofinity Commercial	$289.00
Rate for Payer: Encore Health Key Benefits Commercial	$268.84
Rate for Payer: Healthscope Commercial	$302.44
Rate for Payer: MI Amish Medical Board Commercial	$268.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$252.04
Rate for Payer: PHP Commercial	$285.64
Rate for Payer: Priority Health SBD	$211.71
Rate for Payer: UHC All Payor (Choice/PPO)	$218.43
Rate for Payer: UHC Core	$175.08
Rate for Payer: UHC Exchange	$132.07

CEPHALEXIN 500 MG CAPSULE

Facility

$3.69

Service Code	NDC 60687016311
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$2.32
Max. Negotiated Rate	$3.32
Rate for Payer: Aetna Commercial	$3.14
Rate for Payer: Aetna New Business (MI Preferred)	$2.40
Rate for Payer: Cash Price	$2.95
Rate for Payer: Cofinity Advantage	$2.58
Rate for Payer: Cofinity Commercial	$3.17
Rate for Payer: Encore Health Key Benefits Commercial	$2.95
Rate for Payer: Healthscope Commercial	$3.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.14
Rate for Payer: Opus (Opus Packaging Group) HMA	$2.77
Rate for Payer: PHP Commercial	$3.14
Rate for Payer: Priority Health SBD	$2.32

CEPHALEXIN 500 MG CAPSULE

Facility

$368.60

Service Code	NDC 60687016301
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$144.86
Max. Negotiated Rate	$331.74
Rate for Payer: Aetna Commercial	$313.31
Rate for Payer: Aetna Medicare	$184.30
Rate for Payer: Aetna New Business (MI Preferred)	$239.59
Rate for Payer: BCBS Complete	$147.44
Rate for Payer: Cash Price	$294.88
Rate for Payer: Cofinity Advantage	$258.02
Rate for Payer: Cofinity Commercial	$317.00
Rate for Payer: Encore Health Key Benefits Commercial	$294.88
Rate for Payer: Healthscope Commercial	$331.74
Rate for Payer: MI Amish Medical Board Commercial	$294.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$313.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$276.45
Rate for Payer: PHP Commercial	$313.31
Rate for Payer: Priority Health SBD	$232.22
Rate for Payer: UHC All Payor (Choice/PPO)	$239.59
Rate for Payer: UHC Core	$192.04
Rate for Payer: UHC Exchange	$144.86

CEPHALEXIN 500 MG CAPSULE

Facility

$192.85

Service Code	NDC 00093314701
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$75.79
Max. Negotiated Rate	$173.56
Rate for Payer: Aetna Commercial	$163.92
Rate for Payer: Aetna Medicare	$96.42
Rate for Payer: Aetna New Business (MI Preferred)	$125.35
Rate for Payer: BCBS Complete	$77.14
Rate for Payer: Cash Price	$154.28
Rate for Payer: Cofinity Advantage	$135.00
Rate for Payer: Cofinity Commercial	$165.85
Rate for Payer: Encore Health Key Benefits Commercial	$154.28
Rate for Payer: Healthscope Commercial	$173.56
Rate for Payer: MI Amish Medical Board Commercial	$154.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$163.92
Rate for Payer: Opus (Opus Packaging Group) HMA	$144.64
Rate for Payer: PHP Commercial	$163.92
Rate for Payer: Priority Health SBD	$121.50
Rate for Payer: UHC All Payor (Choice/PPO)	$125.35
Rate for Payer: UHC Core	$100.47
Rate for Payer: UHC Exchange	$75.79

CEPHALEXIN 500 MG CAPSULE

Facility

$368.60

Service Code	NDC 60687016301
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$232.22
Max. Negotiated Rate	$331.74
Rate for Payer: Aetna Commercial	$313.31
Rate for Payer: Aetna New Business (MI Preferred)	$239.59
Rate for Payer: Cash Price	$294.88
Rate for Payer: Cofinity Advantage	$258.02
Rate for Payer: Cofinity Commercial	$317.00
Rate for Payer: Encore Health Key Benefits Commercial	$294.88
Rate for Payer: Healthscope Commercial	$331.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$313.31
Rate for Payer: Opus (Opus Packaging Group) HMA	$276.45
Rate for Payer: PHP Commercial	$313.31
Rate for Payer: Priority Health SBD	$232.22

CEPHALEXIN 500 MG CAPSULE

Facility

$129.20

Service Code	NDC 50268015215
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$50.78
Max. Negotiated Rate	$116.28
Rate for Payer: Aetna Commercial	$109.82
Rate for Payer: Aetna Medicare	$64.60
Rate for Payer: Aetna New Business (MI Preferred)	$83.98
Rate for Payer: BCBS Complete	$51.68
Rate for Payer: Cash Price	$103.36
Rate for Payer: Cofinity Advantage	$90.44
Rate for Payer: Cofinity Commercial	$111.11
Rate for Payer: Encore Health Key Benefits Commercial	$103.36
Rate for Payer: Healthscope Commercial	$116.28
Rate for Payer: MI Amish Medical Board Commercial	$103.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$109.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$96.90
Rate for Payer: PHP Commercial	$109.82
Rate for Payer: Priority Health SBD	$81.40
Rate for Payer: UHC All Payor (Choice/PPO)	$83.98
Rate for Payer: UHC Core	$67.31
Rate for Payer: UHC Exchange	$50.78

CEPHALEXIN 500 MG CAPSULE

Facility

$2.59

Service Code	NDC 50268015211
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$2.33
Rate for Payer: Aetna Commercial	$2.20
Rate for Payer: Aetna New Business (MI Preferred)	$1.68
Rate for Payer: Cash Price	$2.07
Rate for Payer: Cofinity Advantage	$1.81
Rate for Payer: Cofinity Commercial	$2.23
Rate for Payer: Encore Health Key Benefits Commercial	$2.07
Rate for Payer: Healthscope Commercial	$2.33
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$2.20
Rate for Payer: Opus (Opus Packaging Group) HMA	$1.94
Rate for Payer: PHP Commercial	$2.20
Rate for Payer: Priority Health SBD	$1.63

CEPHALEXIN 500 MG CAPSULE

Facility

$336.05

Service Code	NDC 67877021901
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$211.71
Max. Negotiated Rate	$302.44
Rate for Payer: Aetna Commercial	$285.64
Rate for Payer: Aetna New Business (MI Preferred)	$218.43
Rate for Payer: Cash Price	$268.84
Rate for Payer: Cofinity Advantage	$235.24
Rate for Payer: Cofinity Commercial	$289.00
Rate for Payer: Encore Health Key Benefits Commercial	$268.84
Rate for Payer: Healthscope Commercial	$302.44
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$252.04
Rate for Payer: PHP Commercial	$285.64
Rate for Payer: Priority Health SBD	$211.71

CEPHALEXIN 500 MG CAPSULE

Facility

$334.40

Service Code	NDC 00904733761
Hospital Charge Code	9500
Hospital Revenue Code	637
Min. Negotiated Rate	$210.67
Max. Negotiated Rate	$300.96
Rate for Payer: Aetna Commercial	$284.24
Rate for Payer: Aetna New Business (MI Preferred)	$217.36
Rate for Payer: Cash Price	$267.52
Rate for Payer: Cofinity Advantage	$234.08
Rate for Payer: Cofinity Commercial	$287.58
Rate for Payer: Encore Health Key Benefits Commercial	$267.52
Rate for Payer: Healthscope Commercial	$300.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$284.24
Rate for Payer: Opus (Opus Packaging Group) HMA	$250.80
Rate for Payer: PHP Commercial	$284.24
Rate for Payer: Priority Health SBD	$210.67

Know your out-of-pocket cost for care.

All Charges