Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ARIPIPRAZOLE 10 MG TABLET

Facility

$2,008.88

Service Code	NDC 59148000813
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$803.55
Max. Negotiated Rate	$1,807.99
Rate for Payer: Aetna Commercial	$1,707.55
Rate for Payer: Aetna Medicare	$1,004.44
Rate for Payer: Aetna New Business (MI Preferred)	$1,305.77
Rate for Payer: BCBS Complete	$803.55
Rate for Payer: Cash Price	$1,607.10
Rate for Payer: Cofinity Commercial	$1,406.22
Rate for Payer: Cofinity Commercial	$1,727.64
Rate for Payer: Cofinity Medicare Advantage	$1,406.22
Rate for Payer: Encore Health Key Benefits Commercial	$1,607.10
Rate for Payer: Healthscope Commercial	$1,807.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,707.55
Rate for Payer: PHP Commercial	$1,707.55
Rate for Payer: Priority Health Cigna Priority Health	$1,305.77
Rate for Payer: Priority Health SBD	$1,265.59

ARIPIPRAZOLE 10 MG TABLET

Facility

$195.27

Service Code	NDC 43547030403
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$78.11
Max. Negotiated Rate	$175.74
Rate for Payer: Aetna Commercial	$165.98
Rate for Payer: Aetna Medicare	$97.64
Rate for Payer: Aetna New Business (MI Preferred)	$126.93
Rate for Payer: BCBS Complete	$78.11
Rate for Payer: Cash Price	$156.22
Rate for Payer: Cofinity Commercial	$136.69
Rate for Payer: Cofinity Commercial	$167.93
Rate for Payer: Cofinity Medicare Advantage	$136.69
Rate for Payer: Encore Health Key Benefits Commercial	$156.22
Rate for Payer: Healthscope Commercial	$175.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$165.98
Rate for Payer: PHP Commercial	$165.98
Rate for Payer: Priority Health Cigna Priority Health	$126.93
Rate for Payer: Priority Health SBD	$123.02

ARIPIPRAZOLE 10 MG TABLET

Facility

$195.27

Service Code	NDC 43547030403
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$123.02
Max. Negotiated Rate	$175.74
Rate for Payer: Aetna Commercial	$165.98
Rate for Payer: Aetna New Business (MI Preferred)	$126.93
Rate for Payer: Cash Price	$156.22
Rate for Payer: Cofinity Commercial	$136.69
Rate for Payer: Cofinity Commercial	$167.93
Rate for Payer: Cofinity Medicare Advantage	$136.69
Rate for Payer: Encore Health Key Benefits Commercial	$156.22
Rate for Payer: Healthscope Commercial	$175.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$165.98
Rate for Payer: PHP Commercial	$165.98
Rate for Payer: Priority Health Cigna Priority Health	$126.93
Rate for Payer: Priority Health SBD	$123.02

ARIPIPRAZOLE 10 MG TABLET

Facility

$71.54

Service Code	NDC 65162089803
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$28.62
Max. Negotiated Rate	$64.39
Rate for Payer: Aetna Commercial	$60.81
Rate for Payer: Aetna Medicare	$35.77
Rate for Payer: Aetna New Business (MI Preferred)	$46.50
Rate for Payer: BCBS Complete	$28.62
Rate for Payer: Cash Price	$57.23
Rate for Payer: Cofinity Commercial	$50.08
Rate for Payer: Cofinity Commercial	$61.52
Rate for Payer: Cofinity Medicare Advantage	$50.08
Rate for Payer: Encore Health Key Benefits Commercial	$57.23
Rate for Payer: Healthscope Commercial	$64.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$60.81
Rate for Payer: PHP Commercial	$60.81
Rate for Payer: Priority Health Cigna Priority Health	$46.50
Rate for Payer: Priority Health SBD	$45.07

ARIPIPRAZOLE 10 MG TABLET

Facility

$71.54

Service Code	NDC 65162089803
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$45.07
Max. Negotiated Rate	$64.39
Rate for Payer: Aetna Commercial	$60.81
Rate for Payer: Aetna New Business (MI Preferred)	$46.50
Rate for Payer: Cash Price	$57.23
Rate for Payer: Cofinity Commercial	$50.08
Rate for Payer: Cofinity Commercial	$61.52
Rate for Payer: Cofinity Medicare Advantage	$50.08
Rate for Payer: Encore Health Key Benefits Commercial	$57.23
Rate for Payer: Healthscope Commercial	$64.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$60.81
Rate for Payer: PHP Commercial	$60.81
Rate for Payer: Priority Health Cigna Priority Health	$46.50
Rate for Payer: Priority Health SBD	$45.07

ARIPIPRAZOLE 10 MG TABLET

Facility

$93.75

Service Code	NDC 27241005303
Hospital Charge Code	34369
Hospital Revenue Code	637
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$84.38
Rate for Payer: Aetna Commercial	$79.69
Rate for Payer: Aetna Medicare	$46.88
Rate for Payer: Aetna New Business (MI Preferred)	$60.94
Rate for Payer: BCBS Complete	$37.50
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cofinity Commercial	$65.62
Rate for Payer: Cofinity Commercial	$80.62
Rate for Payer: Cofinity Medicare Advantage	$65.62
Rate for Payer: Encore Health Key Benefits Commercial	$75.00
Rate for Payer: Healthscope Commercial	$84.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$79.69
Rate for Payer: PHP Commercial	$79.69
Rate for Payer: Priority Health Cigna Priority Health	$60.94
Rate for Payer: Priority Health SBD	$59.06

ARIPIPRAZOLE 15 MG TABLET

Facility

$61.85

Service Code	NDC 13668021930
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$38.97
Max. Negotiated Rate	$55.66
Rate for Payer: Aetna Commercial	$52.57
Rate for Payer: Aetna New Business (MI Preferred)	$40.20
Rate for Payer: Cash Price	$49.48
Rate for Payer: Cofinity Commercial	$43.30
Rate for Payer: Cofinity Commercial	$53.19
Rate for Payer: Cofinity Medicare Advantage	$43.30
Rate for Payer: Encore Health Key Benefits Commercial	$49.48
Rate for Payer: Healthscope Commercial	$55.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.57
Rate for Payer: PHP Commercial	$52.57
Rate for Payer: Priority Health Cigna Priority Health	$40.20
Rate for Payer: Priority Health SBD	$38.97

ARIPIPRAZOLE 15 MG TABLET

Facility

$591.52

Service Code	NDC 00904651204
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$372.66
Max. Negotiated Rate	$532.37
Rate for Payer: Aetna Commercial	$502.79
Rate for Payer: Aetna New Business (MI Preferred)	$384.49
Rate for Payer: Cash Price	$473.22
Rate for Payer: Cofinity Commercial	$414.06
Rate for Payer: Cofinity Commercial	$508.71
Rate for Payer: Cofinity Medicare Advantage	$414.06
Rate for Payer: Encore Health Key Benefits Commercial	$473.22
Rate for Payer: Healthscope Commercial	$532.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$502.79
Rate for Payer: PHP Commercial	$502.79
Rate for Payer: Priority Health Cigna Priority Health	$384.49
Rate for Payer: Priority Health SBD	$372.66

ARIPIPRAZOLE 15 MG TABLET

Facility

$818.63

Service Code	NDC 60687019121
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$515.74
Max. Negotiated Rate	$736.77
Rate for Payer: Aetna Commercial	$695.84
Rate for Payer: Aetna New Business (MI Preferred)	$532.11
Rate for Payer: Cash Price	$654.90
Rate for Payer: Cofinity Commercial	$573.04
Rate for Payer: Cofinity Commercial	$704.02
Rate for Payer: Cofinity Medicare Advantage	$573.04
Rate for Payer: Encore Health Key Benefits Commercial	$654.90
Rate for Payer: Healthscope Commercial	$736.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$695.84
Rate for Payer: PHP Commercial	$695.84
Rate for Payer: Priority Health Cigna Priority Health	$532.11
Rate for Payer: Priority Health SBD	$515.74

ARIPIPRAZOLE 15 MG TABLET

Facility

$818.63

Service Code	NDC 60687019121
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$327.45
Max. Negotiated Rate	$736.77
Rate for Payer: Aetna Commercial	$695.84
Rate for Payer: Aetna Medicare	$409.31
Rate for Payer: Aetna New Business (MI Preferred)	$532.11
Rate for Payer: BCBS Complete	$327.45
Rate for Payer: Cash Price	$654.90
Rate for Payer: Cofinity Commercial	$573.04
Rate for Payer: Cofinity Commercial	$704.02
Rate for Payer: Cofinity Medicare Advantage	$573.04
Rate for Payer: Encore Health Key Benefits Commercial	$654.90
Rate for Payer: Healthscope Commercial	$736.77
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$695.84
Rate for Payer: PHP Commercial	$695.84
Rate for Payer: Priority Health Cigna Priority Health	$532.11
Rate for Payer: Priority Health SBD	$515.74

ARIPIPRAZOLE 15 MG TABLET

Facility

$591.52

Service Code	NDC 00904651204
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$236.61
Max. Negotiated Rate	$532.37
Rate for Payer: Aetna Commercial	$502.79
Rate for Payer: Aetna Medicare	$295.76
Rate for Payer: Aetna New Business (MI Preferred)	$384.49
Rate for Payer: BCBS Complete	$236.61
Rate for Payer: Cash Price	$473.22
Rate for Payer: Cofinity Commercial	$414.06
Rate for Payer: Cofinity Commercial	$508.71
Rate for Payer: Cofinity Medicare Advantage	$414.06
Rate for Payer: Encore Health Key Benefits Commercial	$473.22
Rate for Payer: Healthscope Commercial	$532.37
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$502.79
Rate for Payer: PHP Commercial	$502.79
Rate for Payer: Priority Health Cigna Priority Health	$384.49
Rate for Payer: Priority Health SBD	$372.66

ARIPIPRAZOLE 15 MG TABLET

Facility

$27.29

Service Code	NDC 60687019111
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$24.56
Rate for Payer: Aetna Commercial	$23.20
Rate for Payer: Aetna Medicare	$13.64
Rate for Payer: Aetna New Business (MI Preferred)	$17.74
Rate for Payer: BCBS Complete	$10.92
Rate for Payer: Cash Price	$21.83
Rate for Payer: Cofinity Commercial	$19.10
Rate for Payer: Cofinity Commercial	$23.47
Rate for Payer: Cofinity Medicare Advantage	$19.10
Rate for Payer: Encore Health Key Benefits Commercial	$21.83
Rate for Payer: Healthscope Commercial	$24.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$23.20
Rate for Payer: PHP Commercial	$23.20
Rate for Payer: Priority Health Cigna Priority Health	$17.74
Rate for Payer: Priority Health SBD	$17.19

ARIPIPRAZOLE 15 MG TABLET

Facility

$27.29

Service Code	NDC 60687019111
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$17.19
Max. Negotiated Rate	$24.56
Rate for Payer: Aetna Commercial	$23.20
Rate for Payer: Aetna New Business (MI Preferred)	$17.74
Rate for Payer: Cash Price	$21.83
Rate for Payer: Cofinity Commercial	$19.10
Rate for Payer: Cofinity Commercial	$23.47
Rate for Payer: Cofinity Medicare Advantage	$19.10
Rate for Payer: Encore Health Key Benefits Commercial	$21.83
Rate for Payer: Healthscope Commercial	$24.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$23.20
Rate for Payer: PHP Commercial	$23.20
Rate for Payer: Priority Health Cigna Priority Health	$17.74
Rate for Payer: Priority Health SBD	$17.19

ARIPIPRAZOLE 15 MG TABLET

Facility

$61.85

Service Code	NDC 13668021930
Hospital Charge Code	34370
Hospital Revenue Code	637
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$55.66
Rate for Payer: Aetna Commercial	$52.57
Rate for Payer: Aetna Medicare	$30.93
Rate for Payer: Aetna New Business (MI Preferred)	$40.20
Rate for Payer: BCBS Complete	$24.74
Rate for Payer: Cash Price	$49.48
Rate for Payer: Cofinity Commercial	$43.30
Rate for Payer: Cofinity Commercial	$53.19
Rate for Payer: Cofinity Medicare Advantage	$43.30
Rate for Payer: Encore Health Key Benefits Commercial	$49.48
Rate for Payer: Healthscope Commercial	$55.66
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.57
Rate for Payer: PHP Commercial	$52.57
Rate for Payer: Priority Health Cigna Priority Health	$40.20
Rate for Payer: Priority Health SBD	$38.97

ARIPIPRAZOLE 2 MG TABLET

Facility

$62.70

Service Code	NDC 65162089603
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$39.50
Max. Negotiated Rate	$56.43
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna New Business (MI Preferred)	$40.76
Rate for Payer: Cash Price	$50.16
Rate for Payer: Cofinity Commercial	$43.89
Rate for Payer: Cofinity Commercial	$53.92
Rate for Payer: Cofinity Medicare Advantage	$43.89
Rate for Payer: Encore Health Key Benefits Commercial	$50.16
Rate for Payer: Healthscope Commercial	$56.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.30
Rate for Payer: PHP Commercial	$53.30
Rate for Payer: Priority Health Cigna Priority Health	$40.76
Rate for Payer: Priority Health SBD	$39.50

ARIPIPRAZOLE 2 MG TABLET

Facility

$62.70

Service Code	NDC 67877043003
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$39.50
Max. Negotiated Rate	$56.43
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna New Business (MI Preferred)	$40.76
Rate for Payer: Cash Price	$50.16
Rate for Payer: Cofinity Commercial	$43.89
Rate for Payer: Cofinity Commercial	$53.92
Rate for Payer: Cofinity Medicare Advantage	$43.89
Rate for Payer: Encore Health Key Benefits Commercial	$50.16
Rate for Payer: Healthscope Commercial	$56.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.30
Rate for Payer: PHP Commercial	$53.30
Rate for Payer: Priority Health Cigna Priority Health	$40.76
Rate for Payer: Priority Health SBD	$39.50

ARIPIPRAZOLE 2 MG TABLET

Facility

$93.75

Service Code	NDC 27241005103
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$59.06
Max. Negotiated Rate	$84.38
Rate for Payer: Aetna Commercial	$79.69
Rate for Payer: Aetna New Business (MI Preferred)	$60.94
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cofinity Commercial	$65.62
Rate for Payer: Cofinity Commercial	$80.62
Rate for Payer: Cofinity Medicare Advantage	$65.62
Rate for Payer: Encore Health Key Benefits Commercial	$75.00
Rate for Payer: Healthscope Commercial	$84.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$79.69
Rate for Payer: PHP Commercial	$79.69
Rate for Payer: Priority Health Cigna Priority Health	$60.94
Rate for Payer: Priority Health SBD	$59.06

ARIPIPRAZOLE 2 MG TABLET

Facility

$62.70

Service Code	NDC 67877043003
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$25.08
Max. Negotiated Rate	$56.43
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare	$31.35
Rate for Payer: Aetna New Business (MI Preferred)	$40.76
Rate for Payer: BCBS Complete	$25.08
Rate for Payer: Cash Price	$50.16
Rate for Payer: Cofinity Commercial	$43.89
Rate for Payer: Cofinity Commercial	$53.92
Rate for Payer: Cofinity Medicare Advantage	$43.89
Rate for Payer: Encore Health Key Benefits Commercial	$50.16
Rate for Payer: Healthscope Commercial	$56.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.30
Rate for Payer: PHP Commercial	$53.30
Rate for Payer: Priority Health Cigna Priority Health	$40.76
Rate for Payer: Priority Health SBD	$39.50

ARIPIPRAZOLE 2 MG TABLET

Facility

$2,008.88

Service Code	NDC 59148000613
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$1,265.59
Max. Negotiated Rate	$1,807.99
Rate for Payer: Aetna Commercial	$1,707.55
Rate for Payer: Aetna New Business (MI Preferred)	$1,305.77
Rate for Payer: Cash Price	$1,607.10
Rate for Payer: Cofinity Commercial	$1,406.22
Rate for Payer: Cofinity Commercial	$1,727.64
Rate for Payer: Cofinity Medicare Advantage	$1,406.22
Rate for Payer: Encore Health Key Benefits Commercial	$1,607.10
Rate for Payer: Healthscope Commercial	$1,807.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,707.55
Rate for Payer: PHP Commercial	$1,707.55
Rate for Payer: Priority Health Cigna Priority Health	$1,305.77
Rate for Payer: Priority Health SBD	$1,265.59

ARIPIPRAZOLE 2 MG TABLET

Facility

$200.31

Service Code	NDC 60505307503
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$126.20
Max. Negotiated Rate	$180.28
Rate for Payer: Aetna Commercial	$170.26
Rate for Payer: Aetna New Business (MI Preferred)	$130.20
Rate for Payer: Cash Price	$160.25
Rate for Payer: Cofinity Commercial	$140.22
Rate for Payer: Cofinity Commercial	$172.27
Rate for Payer: Cofinity Medicare Advantage	$140.22
Rate for Payer: Encore Health Key Benefits Commercial	$160.25
Rate for Payer: Healthscope Commercial	$180.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.26
Rate for Payer: PHP Commercial	$170.26
Rate for Payer: Priority Health Cigna Priority Health	$130.20
Rate for Payer: Priority Health SBD	$126.20

ARIPIPRAZOLE 2 MG TABLET

Facility

$62.70

Service Code	NDC 65162089603
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$25.08
Max. Negotiated Rate	$56.43
Rate for Payer: Aetna Commercial	$53.30
Rate for Payer: Aetna Medicare	$31.35
Rate for Payer: Aetna New Business (MI Preferred)	$40.76
Rate for Payer: BCBS Complete	$25.08
Rate for Payer: Cash Price	$50.16
Rate for Payer: Cofinity Commercial	$43.89
Rate for Payer: Cofinity Commercial	$53.92
Rate for Payer: Cofinity Medicare Advantage	$43.89
Rate for Payer: Encore Health Key Benefits Commercial	$50.16
Rate for Payer: Healthscope Commercial	$56.43
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$53.30
Rate for Payer: PHP Commercial	$53.30
Rate for Payer: Priority Health Cigna Priority Health	$40.76
Rate for Payer: Priority Health SBD	$39.50

ARIPIPRAZOLE 2 MG TABLET

Facility

$2,008.88

Service Code	NDC 59148000613
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$803.55
Max. Negotiated Rate	$1,807.99
Rate for Payer: Aetna Commercial	$1,707.55
Rate for Payer: Aetna Medicare	$1,004.44
Rate for Payer: Aetna New Business (MI Preferred)	$1,305.77
Rate for Payer: BCBS Complete	$803.55
Rate for Payer: Cash Price	$1,607.10
Rate for Payer: Cofinity Commercial	$1,406.22
Rate for Payer: Cofinity Commercial	$1,727.64
Rate for Payer: Cofinity Medicare Advantage	$1,406.22
Rate for Payer: Encore Health Key Benefits Commercial	$1,607.10
Rate for Payer: Healthscope Commercial	$1,807.99
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,707.55
Rate for Payer: PHP Commercial	$1,707.55
Rate for Payer: Priority Health Cigna Priority Health	$1,305.77
Rate for Payer: Priority Health SBD	$1,265.59

ARIPIPRAZOLE 2 MG TABLET

Facility

$93.75

Service Code	NDC 27241005103
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$84.38
Rate for Payer: Aetna Commercial	$79.69
Rate for Payer: Aetna Medicare	$46.88
Rate for Payer: Aetna New Business (MI Preferred)	$60.94
Rate for Payer: BCBS Complete	$37.50
Rate for Payer: Cash Price	$75.00
Rate for Payer: Cofinity Commercial	$65.62
Rate for Payer: Cofinity Commercial	$80.62
Rate for Payer: Cofinity Medicare Advantage	$65.62
Rate for Payer: Encore Health Key Benefits Commercial	$75.00
Rate for Payer: Healthscope Commercial	$84.38
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$79.69
Rate for Payer: PHP Commercial	$79.69
Rate for Payer: Priority Health Cigna Priority Health	$60.94
Rate for Payer: Priority Health SBD	$59.06

ARIPIPRAZOLE 2 MG TABLET

Facility

$200.31

Service Code	NDC 60505307503
Hospital Charge Code	70306
Hospital Revenue Code	637
Min. Negotiated Rate	$80.12
Max. Negotiated Rate	$180.28
Rate for Payer: Aetna Commercial	$170.26
Rate for Payer: Aetna Medicare	$100.16
Rate for Payer: Aetna New Business (MI Preferred)	$130.20
Rate for Payer: BCBS Complete	$80.12
Rate for Payer: Cash Price	$160.25
Rate for Payer: Cofinity Commercial	$140.22
Rate for Payer: Cofinity Commercial	$172.27
Rate for Payer: Cofinity Medicare Advantage	$140.22
Rate for Payer: Encore Health Key Benefits Commercial	$160.25
Rate for Payer: Healthscope Commercial	$180.28
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.26
Rate for Payer: PHP Commercial	$170.26
Rate for Payer: Priority Health Cigna Priority Health	$130.20
Rate for Payer: Priority Health SBD	$126.20

ARIPIPRAZOLE 5 MG TABLET

Facility

$1,831.87

Service Code	NDC 00904651061
Hospital Charge Code	36438
Hospital Revenue Code	637
Min. Negotiated Rate	$732.75
Max. Negotiated Rate	$1,648.68
Rate for Payer: Aetna Commercial	$1,557.09
Rate for Payer: Aetna Medicare	$915.93
Rate for Payer: Aetna New Business (MI Preferred)	$1,190.72
Rate for Payer: BCBS Complete	$732.75
Rate for Payer: Cash Price	$1,465.50
Rate for Payer: Cofinity Commercial	$1,282.31
Rate for Payer: Cofinity Commercial	$1,575.41
Rate for Payer: Cofinity Medicare Advantage	$1,282.31
Rate for Payer: Encore Health Key Benefits Commercial	$1,465.50
Rate for Payer: Healthscope Commercial	$1,648.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,557.09
Rate for Payer: PHP Commercial	$1,557.09
Rate for Payer: Priority Health Cigna Priority Health	$1,190.72
Rate for Payer: Priority Health SBD	$1,154.08

Know your out-of-pocket cost for care.

All Charges