Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

NEPHRITIS AND NEPHROSIS

Facility

$21,721.19

Service Code	APR-DRG 4624
Min. Negotiated Rate	$20,686.85
Max. Negotiated Rate	$21,721.19
Rate for Payer: BCBS Complete	$21,721.19
Rate for Payer: Mclaren Medicaid	$20,686.85
Rate for Payer: Meridian Medicaid	$21,721.19
Rate for Payer: Priority Health Choice Medicaid	$20,686.85
Rate for Payer: UHC Medicaid	$20,686.85
Rate for Payer: UHCCP Medicaid	$20,686.85

NERVOUS SYSTEM MALIGNANCY

Facility

$11,588.11

Service Code	APR-DRG 0414
Min. Negotiated Rate	$11,036.30
Max. Negotiated Rate	$11,588.11
Rate for Payer: BCBS Complete	$11,588.11
Rate for Payer: Mclaren Medicaid	$11,036.30
Rate for Payer: Meridian Medicaid	$11,588.11
Rate for Payer: Priority Health Choice Medicaid	$11,036.30
Rate for Payer: UHC Medicaid	$11,036.30
Rate for Payer: UHCCP Medicaid	$11,036.30

NERVOUS SYSTEM MALIGNANCY

Facility

$4,292.87

Service Code	APR-DRG 0411
Min. Negotiated Rate	$4,088.45
Max. Negotiated Rate	$4,292.87
Rate for Payer: BCBS Complete	$4,292.87
Rate for Payer: Mclaren Medicaid	$4,088.45
Rate for Payer: Meridian Medicaid	$4,292.87
Rate for Payer: Priority Health Choice Medicaid	$4,088.45
Rate for Payer: UHC Medicaid	$4,088.45
Rate for Payer: UHCCP Medicaid	$4,088.45

NERVOUS SYSTEM MALIGNANCY

Facility

$5,585.66

Service Code	APR-DRG 0412
Min. Negotiated Rate	$5,319.68
Max. Negotiated Rate	$5,585.66
Rate for Payer: BCBS Complete	$5,585.66
Rate for Payer: Mclaren Medicaid	$5,319.68
Rate for Payer: Meridian Medicaid	$5,585.66
Rate for Payer: Priority Health Choice Medicaid	$5,319.68
Rate for Payer: UHC Medicaid	$5,319.68
Rate for Payer: UHCCP Medicaid	$5,319.68

NERVOUS SYSTEM MALIGNANCY

Facility

$8,442.99

Service Code	APR-DRG 0413
Min. Negotiated Rate	$8,040.94
Max. Negotiated Rate	$8,442.99
Rate for Payer: BCBS Complete	$8,442.99
Rate for Payer: Mclaren Medicaid	$8,040.94
Rate for Payer: Meridian Medicaid	$8,442.99
Rate for Payer: Priority Health Choice Medicaid	$8,040.94
Rate for Payer: UHC Medicaid	$8,040.94
Rate for Payer: UHCCP Medicaid	$8,040.94

NERVOUS SYSTEM NEOPLASMS WITH MCC

Facility

$24,888.47

Service Code	MSDRG 054
Min. Negotiated Rate	$11,760.28
Max. Negotiated Rate	$24,888.47
Rate for Payer: Aetna Medicare	$12,874.41
Rate for Payer: Allen County Amish Medical Aid Commercial	$15,474.05
Rate for Payer: Amish Plain Church Group Commercial	$15,474.05
Rate for Payer: BCBS MAPPO	$12,379.24
Rate for Payer: BCBS Trust/PPO	$23,656.12
Rate for Payer: BCN Commercial	$23,656.12
Rate for Payer: BCN Medicare Advantage	$12,379.24
Rate for Payer: Health Alliance Plan Medicare Advantage	$12,379.24
Rate for Payer: Mclaren Medicare	$12,379.24
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$12,998.20
Rate for Payer: MI Amish Medical Board Commercial	$14,236.13
Rate for Payer: Molina Medicare/Medicaid	$13,617.16
Rate for Payer: Nomi Health Commercial	$19,697.01
Rate for Payer: PACE Medicare	$11,760.28
Rate for Payer: PACE SWMI	$12,379.24
Rate for Payer: PHP Medicare Advantage	$12,379.24
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$24,616.90
Rate for Payer: Priority Health Medicare	$12,379.24
Rate for Payer: Priority Health Tiered Network	$19,693.51
Rate for Payer: Railroad Medicare Medicare	$12,379.24
Rate for Payer: UHC All Payor (Choice/PPO)	$24,888.47
Rate for Payer: UHC Core	$20,822.34
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$12,379.24
Rate for Payer: UHC Exchange	$17,005.09
Rate for Payer: VA VA	$12,379.24

NERVOUS SYSTEM NEOPLASMS WITHOUT MCC

Facility

$22,284.42

Service Code	MSDRG 055
Min. Negotiated Rate	$8,035.77
Max. Negotiated Rate	$22,284.42
Rate for Payer: Aetna Medicare	$8,797.05
Rate for Payer: Allen County Amish Medical Aid Commercial	$10,573.38
Rate for Payer: Amish Plain Church Group Commercial	$10,573.38
Rate for Payer: BCBS MAPPO	$8,458.70
Rate for Payer: BCBS Trust/PPO	$22,284.42
Rate for Payer: BCN Commercial	$22,284.42
Rate for Payer: BCN Medicare Advantage	$8,458.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,458.70
Rate for Payer: Mclaren Medicare	$8,458.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$8,881.64
Rate for Payer: MI Amish Medical Board Commercial	$9,727.50
Rate for Payer: Molina Medicare/Medicaid	$9,304.57
Rate for Payer: Nomi Health Commercial	$13,152.84
Rate for Payer: PACE Medicare	$8,035.77
Rate for Payer: PACE SWMI	$8,458.70
Rate for Payer: PHP Medicare Advantage	$8,458.70
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$16,438.13
Rate for Payer: Priority Health Medicare	$8,458.70
Rate for Payer: Priority Health Tiered Network	$13,150.51
Rate for Payer: Railroad Medicare Medicare	$8,458.70
Rate for Payer: UHC All Payor (Choice/PPO)	$16,619.48
Rate for Payer: UHC Core	$13,904.29
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,458.70
Rate for Payer: UHC Exchange	$11,355.29
Rate for Payer: VA VA	$8,458.70

NETARSUDIL 0.02 % EYE DROPS

Facility

$1,120.39

Service Code	NDC 70727049725
Hospital Charge Code	186103
Hospital Revenue Code	637
Min. Negotiated Rate	$705.85
Max. Negotiated Rate	$1,008.35
Rate for Payer: Aetna Commercial	$952.33
Rate for Payer: Aetna New Business (MI Preferred)	$728.25
Rate for Payer: Cash Price	$896.31
Rate for Payer: Cofinity Advantage	$784.27
Rate for Payer: Cofinity Commercial	$963.54
Rate for Payer: Encore Health Key Benefits Commercial	$896.31
Rate for Payer: Healthscope Commercial	$1,008.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$952.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$840.29
Rate for Payer: PHP Commercial	$952.33
Rate for Payer: Priority Health SBD	$705.85

NETARSUDIL 0.02 % EYE DROPS

Facility

$1,120.39

Service Code	NDC 70727049725
Hospital Charge Code	186103
Hospital Revenue Code	637
Min. Negotiated Rate	$440.31
Max. Negotiated Rate	$1,008.35
Rate for Payer: Aetna Commercial	$952.33
Rate for Payer: Aetna Medicare	$560.20
Rate for Payer: Aetna New Business (MI Preferred)	$728.25
Rate for Payer: BCBS Complete	$448.16
Rate for Payer: Cash Price	$896.31
Rate for Payer: Cofinity Advantage	$784.27
Rate for Payer: Cofinity Commercial	$963.54
Rate for Payer: Encore Health Key Benefits Commercial	$896.31
Rate for Payer: Healthscope Commercial	$1,008.35
Rate for Payer: MI Amish Medical Board Commercial	$896.31
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$952.33
Rate for Payer: Opus (Opus Packaging Group) HMA	$840.29
Rate for Payer: PHP Commercial	$952.33
Rate for Payer: Priority Health SBD	$705.85
Rate for Payer: UHC All Payor (Choice/PPO)	$728.25
Rate for Payer: UHC Core	$583.72
Rate for Payer: UHC Exchange	$440.31

NETARSUDIL 0.02 %-LATANOPROST 0.005 % EYE DROPS

Facility

$1,185.52

Service Code	NDC 70727052925
Hospital Charge Code	189942
Hospital Revenue Code	637
Min. Negotiated Rate	$465.91
Max. Negotiated Rate	$1,066.97
Rate for Payer: Aetna Commercial	$1,007.69
Rate for Payer: Aetna Medicare	$592.76
Rate for Payer: Aetna New Business (MI Preferred)	$770.59
Rate for Payer: BCBS Complete	$474.21
Rate for Payer: Cash Price	$948.42
Rate for Payer: Cofinity Advantage	$829.86
Rate for Payer: Cofinity Commercial	$1,019.55
Rate for Payer: Encore Health Key Benefits Commercial	$948.42
Rate for Payer: Healthscope Commercial	$1,066.97
Rate for Payer: MI Amish Medical Board Commercial	$948.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,007.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$889.14
Rate for Payer: PHP Commercial	$1,007.69
Rate for Payer: Priority Health SBD	$746.88
Rate for Payer: UHC All Payor (Choice/PPO)	$770.59
Rate for Payer: UHC Core	$617.66
Rate for Payer: UHC Exchange	$465.91

NETARSUDIL 0.02 %-LATANOPROST 0.005 % EYE DROPS

Facility

$1,185.52

Service Code	NDC 70727052925
Hospital Charge Code	189942
Hospital Revenue Code	637
Min. Negotiated Rate	$746.88
Max. Negotiated Rate	$1,066.97
Rate for Payer: Aetna Commercial	$1,007.69
Rate for Payer: Aetna New Business (MI Preferred)	$770.59
Rate for Payer: Cash Price	$948.42
Rate for Payer: Cofinity Advantage	$829.86
Rate for Payer: Cofinity Commercial	$1,019.55
Rate for Payer: Encore Health Key Benefits Commercial	$948.42
Rate for Payer: Healthscope Commercial	$1,066.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,007.69
Rate for Payer: Opus (Opus Packaging Group) HMA	$889.14
Rate for Payer: PHP Commercial	$1,007.69
Rate for Payer: Priority Health SBD	$746.88

NEUROLOGICAL EYE DISORDERS

Facility

$19,653.36

Service Code	MSDRG 123
Min. Negotiated Rate	$6,413.23
Max. Negotiated Rate	$19,653.36
Rate for Payer: Aetna Medicare	$7,020.80
Rate for Payer: Allen County Amish Medical Aid Commercial	$8,438.46
Rate for Payer: Amish Plain Church Group Commercial	$8,438.46
Rate for Payer: BCBS MAPPO	$6,750.77
Rate for Payer: BCBS Trust/PPO	$19,653.36
Rate for Payer: BCN Commercial	$19,653.36
Rate for Payer: BCN Medicare Advantage	$6,750.77
Rate for Payer: Health Alliance Plan Medicare Advantage	$6,750.77
Rate for Payer: Mclaren Medicare	$6,750.77
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$7,088.31
Rate for Payer: MI Amish Medical Board Commercial	$7,763.39
Rate for Payer: Molina Medicare/Medicaid	$7,425.85
Rate for Payer: Nomi Health Commercial	$10,301.94
Rate for Payer: PACE Medicare	$6,413.23
Rate for Payer: PACE SWMI	$6,750.77
Rate for Payer: PHP Medicare Advantage	$6,750.77
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$12,875.14
Rate for Payer: Priority Health Medicare	$6,750.77
Rate for Payer: Priority Health Tiered Network	$10,300.11
Rate for Payer: Railroad Medicare Medicare	$6,750.77
Rate for Payer: UHC All Payor (Choice/PPO)	$13,017.18
Rate for Payer: UHC Core	$10,890.51
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$6,750.77
Rate for Payer: UHC Exchange	$8,894.01
Rate for Payer: VA VA	$6,750.77

NEUROPLASTY AND/OR TRANSPOSITION; MEDIAN NERVE AT CARPAL TUNNEL

Facility

$6,292.24

Service Code	CPT 64721
Hospital Revenue Code	360
Min. Negotiated Rate	$1,017.60
Max. Negotiated Rate	$6,292.24
Rate for Payer: Aetna Medicare	$2,023.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,432.12
Rate for Payer: Amish Plain Church Group Commercial	$2,432.12
Rate for Payer: BCBS Complete	$1,068.58
Rate for Payer: BCBS MAPPO	$1,945.70
Rate for Payer: BCBS Trust/PPO	$1,469.90
Rate for Payer: BCN Commercial	$1,469.90
Rate for Payer: BCN Medicare Advantage	$1,945.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,945.70
Rate for Payer: Mclaren Medicaid	$1,017.60
Rate for Payer: Mclaren Medicare	$1,945.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,042.98
Rate for Payer: Meridian Medicaid	$2,042.98
Rate for Payer: MI Amish Medical Board Commercial	$2,237.55
Rate for Payer: Molina Medicare/Medicaid	$2,140.27
Rate for Payer: Nomi Health Commercial	$5,837.10
Rate for Payer: PACE Medicare	$1,848.41
Rate for Payer: PACE SWMI	$1,945.70
Rate for Payer: PHP Medicare Advantage	$1,945.70
Rate for Payer: Priority Health Choice Medicaid	$1,017.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$6,292.24
Rate for Payer: Priority Health Medicare	$1,945.70
Rate for Payer: Priority Health Tiered Network	$5,033.79
Rate for Payer: Railroad Medicare Medicare	$1,945.70
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,945.70
Rate for Payer: UHC Medicaid	$1,017.60
Rate for Payer: UHCCP Medicaid	$1,017.60
Rate for Payer: VA VA	$1,945.70

NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW

Facility

$6,292.24

Service Code	CPT 64718
Hospital Revenue Code	360
Min. Negotiated Rate	$1,017.60
Max. Negotiated Rate	$6,292.24
Rate for Payer: Aetna Medicare	$2,023.53
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,432.12
Rate for Payer: Amish Plain Church Group Commercial	$2,432.12
Rate for Payer: BCBS Complete	$1,068.58
Rate for Payer: BCBS MAPPO	$1,945.70
Rate for Payer: BCBS Trust/PPO	$2,332.35
Rate for Payer: BCN Commercial	$2,332.35
Rate for Payer: BCN Medicare Advantage	$1,945.70
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,945.70
Rate for Payer: Mclaren Medicaid	$1,017.60
Rate for Payer: Mclaren Medicare	$1,945.70
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,042.98
Rate for Payer: Meridian Medicaid	$2,042.98
Rate for Payer: MI Amish Medical Board Commercial	$2,237.55
Rate for Payer: Molina Medicare/Medicaid	$2,140.27
Rate for Payer: Nomi Health Commercial	$5,837.10
Rate for Payer: PACE Medicare	$1,848.41
Rate for Payer: PACE SWMI	$1,945.70
Rate for Payer: PHP Medicare Advantage	$1,945.70
Rate for Payer: Priority Health Choice Medicaid	$1,017.60
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$6,292.24
Rate for Payer: Priority Health Medicare	$1,945.70
Rate for Payer: Priority Health Tiered Network	$5,033.79
Rate for Payer: Railroad Medicare Medicare	$1,945.70
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$1,945.70
Rate for Payer: UHC Medicaid	$1,017.60
Rate for Payer: UHCCP Medicaid	$1,017.60
Rate for Payer: VA VA	$1,945.70

NEUROSES EXCEPT DEPRESSIVE

Facility

$26,132.69

Service Code	MSDRG 882
Min. Negotiated Rate	$1,069.00
Max. Negotiated Rate	$26,132.69
Rate for Payer: Aetna Medicare	$9,232.67
Rate for Payer: Allen County Amish Medical Aid Commercial	$11,096.96
Rate for Payer: Amish Plain Church Group Commercial	$11,096.96
Rate for Payer: BCBS MAPPO	$8,877.57
Rate for Payer: BCBS Trust/PPO	$26,132.69
Rate for Payer: BCN Commercial	$26,132.69
Rate for Payer: BCN Medicare Advantage	$8,877.57
Rate for Payer: Health Alliance Plan Medicare Advantage	$8,877.57
Rate for Payer: Mclaren Medicare	$8,877.57
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$9,321.45
Rate for Payer: MI Amish Medical Board Commercial	$10,209.21
Rate for Payer: Molina Medicare/Medicaid	$9,765.33
Rate for Payer: Nomi Health Commercial	$1,069.00
Rate for Payer: PACE Medicare	$8,433.69
Rate for Payer: PACE SWMI	$8,877.57
Rate for Payer: PHP Medicare Advantage	$8,877.57
Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network	$17,311.95
Rate for Payer: Priority Health Medicare	$8,877.57
Rate for Payer: Priority Health Tiered Network	$13,849.56
Rate for Payer: Railroad Medicare Medicare	$8,877.57
Rate for Payer: UHC All Payor (Choice/PPO)	$17,502.94
Rate for Payer: UHC Core	$14,643.41
Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage	$8,877.57
Rate for Payer: UHC Exchange	$11,958.91
Rate for Payer: VA VA	$8,877.57

NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$6.70

Service Code	NDC 50268058411
Hospital Charge Code	5545
Hospital Revenue Code	637
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$6.03
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare	$3.35
Rate for Payer: Aetna New Business (MI Preferred)	$4.36
Rate for Payer: BCBS Complete	$2.68
Rate for Payer: Cash Price	$5.36
Rate for Payer: Cofinity Advantage	$4.69
Rate for Payer: Cofinity Commercial	$5.76
Rate for Payer: Encore Health Key Benefits Commercial	$5.36
Rate for Payer: Healthscope Commercial	$6.03
Rate for Payer: MI Amish Medical Board Commercial	$5.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.03
Rate for Payer: PHP Commercial	$5.70
Rate for Payer: Priority Health SBD	$4.22
Rate for Payer: UHC All Payor (Choice/PPO)	$4.36
Rate for Payer: UHC Core	$3.49
Rate for Payer: UHC Exchange	$2.63

NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$200.74

Service Code	NDC 50268058413
Hospital Charge Code	5545
Hospital Revenue Code	637
Min. Negotiated Rate	$126.47
Max. Negotiated Rate	$180.67
Rate for Payer: Aetna Commercial	$170.63
Rate for Payer: Aetna New Business (MI Preferred)	$130.48
Rate for Payer: Cash Price	$160.59
Rate for Payer: Cofinity Advantage	$140.52
Rate for Payer: Cofinity Commercial	$172.64
Rate for Payer: Encore Health Key Benefits Commercial	$160.59
Rate for Payer: Healthscope Commercial	$180.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$150.56
Rate for Payer: PHP Commercial	$170.63
Rate for Payer: Priority Health SBD	$126.47

NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$6.70

Service Code	NDC 50268058411
Hospital Charge Code	5545
Hospital Revenue Code	637
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$6.03
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna New Business (MI Preferred)	$4.36
Rate for Payer: Cash Price	$5.36
Rate for Payer: Cofinity Advantage	$4.69
Rate for Payer: Cofinity Commercial	$5.76
Rate for Payer: Encore Health Key Benefits Commercial	$5.36
Rate for Payer: Healthscope Commercial	$6.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$5.70
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.03
Rate for Payer: PHP Commercial	$5.70
Rate for Payer: Priority Health SBD	$4.22

NIACIN ER 500 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$200.74

Service Code	NDC 50268058413
Hospital Charge Code	5545
Hospital Revenue Code	637
Min. Negotiated Rate	$78.89
Max. Negotiated Rate	$180.67
Rate for Payer: Aetna Commercial	$170.63
Rate for Payer: Aetna Medicare	$100.37
Rate for Payer: Aetna New Business (MI Preferred)	$130.48
Rate for Payer: BCBS Complete	$80.30
Rate for Payer: Cash Price	$160.59
Rate for Payer: Cofinity Advantage	$140.52
Rate for Payer: Cofinity Commercial	$172.64
Rate for Payer: Encore Health Key Benefits Commercial	$160.59
Rate for Payer: Healthscope Commercial	$180.67
Rate for Payer: MI Amish Medical Board Commercial	$160.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$170.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$150.56
Rate for Payer: PHP Commercial	$170.63
Rate for Payer: Priority Health SBD	$126.47
Rate for Payer: UHC All Payor (Choice/PPO)	$130.48
Rate for Payer: UHC Core	$104.59
Rate for Payer: UHC Exchange	$78.89

NICARDIPINE 20 MG CAPSULE

Facility

$669.60

Service Code	NDC 42806050109
Hospital Charge Code	10712
Hospital Revenue Code	637
Min. Negotiated Rate	$421.85
Max. Negotiated Rate	$602.64
Rate for Payer: Aetna Commercial	$569.16
Rate for Payer: Aetna New Business (MI Preferred)	$435.24
Rate for Payer: Cash Price	$535.68
Rate for Payer: Cofinity Advantage	$468.72
Rate for Payer: Cofinity Commercial	$575.86
Rate for Payer: Encore Health Key Benefits Commercial	$535.68
Rate for Payer: Healthscope Commercial	$602.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$569.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$502.20
Rate for Payer: PHP Commercial	$569.16
Rate for Payer: Priority Health SBD	$421.85

NICARDIPINE 20 MG CAPSULE

Facility

$669.60

Service Code	NDC 42806050109
Hospital Charge Code	10712
Hospital Revenue Code	637
Min. Negotiated Rate	$263.15
Max. Negotiated Rate	$602.64
Rate for Payer: Aetna Commercial	$569.16
Rate for Payer: Aetna Medicare	$334.80
Rate for Payer: Aetna New Business (MI Preferred)	$435.24
Rate for Payer: BCBS Complete	$267.84
Rate for Payer: Cash Price	$535.68
Rate for Payer: Cofinity Advantage	$468.72
Rate for Payer: Cofinity Commercial	$575.86
Rate for Payer: Encore Health Key Benefits Commercial	$535.68
Rate for Payer: Healthscope Commercial	$602.64
Rate for Payer: MI Amish Medical Board Commercial	$535.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$569.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$502.20
Rate for Payer: PHP Commercial	$569.16
Rate for Payer: Priority Health SBD	$421.85
Rate for Payer: UHC All Payor (Choice/PPO)	$435.24
Rate for Payer: UHC Core	$348.86
Rate for Payer: UHC Exchange	$263.15

NICARDIPINE 20 MG CAPSULE

Facility

$714.96

Service Code	NDC 00378102077
Hospital Charge Code	10712
Hospital Revenue Code	637
Min. Negotiated Rate	$280.98
Max. Negotiated Rate	$643.46
Rate for Payer: Aetna Commercial	$607.72
Rate for Payer: Aetna Medicare	$357.48
Rate for Payer: Aetna New Business (MI Preferred)	$464.72
Rate for Payer: BCBS Complete	$285.98
Rate for Payer: Cash Price	$571.97
Rate for Payer: Cofinity Advantage	$500.47
Rate for Payer: Cofinity Commercial	$614.87
Rate for Payer: Encore Health Key Benefits Commercial	$571.97
Rate for Payer: Healthscope Commercial	$643.46
Rate for Payer: MI Amish Medical Board Commercial	$571.97
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$607.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$536.22
Rate for Payer: PHP Commercial	$607.72
Rate for Payer: Priority Health SBD	$450.42
Rate for Payer: UHC All Payor (Choice/PPO)	$464.72
Rate for Payer: UHC Core	$372.49
Rate for Payer: UHC Exchange	$280.98

NICARDIPINE 20 MG CAPSULE

Facility

$714.96

Service Code	NDC 00378102077
Hospital Charge Code	10712
Hospital Revenue Code	637
Min. Negotiated Rate	$450.42
Max. Negotiated Rate	$643.46
Rate for Payer: Aetna Commercial	$607.72
Rate for Payer: Aetna New Business (MI Preferred)	$464.72
Rate for Payer: Cash Price	$571.97
Rate for Payer: Cofinity Advantage	$500.47
Rate for Payer: Cofinity Commercial	$614.87
Rate for Payer: Encore Health Key Benefits Commercial	$571.97
Rate for Payer: Healthscope Commercial	$643.46
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$607.72
Rate for Payer: Opus (Opus Packaging Group) HMA	$536.22
Rate for Payer: PHP Commercial	$607.72
Rate for Payer: Priority Health SBD	$450.42

NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION

Facility

$38.72

Service Code	HCPCS J2404
Hospital Charge Code	12370
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$34.85
Rate for Payer: Aetna Commercial	$32.91
Rate for Payer: Aetna Commercial	$33.59
Rate for Payer: Aetna Commercial	$44.00
Rate for Payer: Aetna Medicare	$19.36
Rate for Payer: Aetna Medicare	$19.76
Rate for Payer: Aetna Medicare	$25.88
Rate for Payer: Aetna New Business (MI Preferred)	$25.17
Rate for Payer: Aetna New Business (MI Preferred)	$25.69
Rate for Payer: Aetna New Business (MI Preferred)	$33.64
Rate for Payer: BCBS Complete	$20.70
Rate for Payer: BCBS Complete	$15.49
Rate for Payer: BCBS Complete	$15.81
Rate for Payer: BCBS Trust/PPO	$0.15
Rate for Payer: BCBS Trust/PPO	$0.15
Rate for Payer: BCBS Trust/PPO	$0.15
Rate for Payer: BCN Commercial	$0.15
Rate for Payer: BCN Commercial	$0.15
Rate for Payer: BCN Commercial	$0.15
Rate for Payer: Cash Price	$41.41
Rate for Payer: Cash Price	$30.98
Rate for Payer: Cash Price	$30.98
Rate for Payer: Cash Price	$31.62
Rate for Payer: Cash Price	$41.41
Rate for Payer: Cash Price	$31.62
Rate for Payer: Cofinity Advantage	$27.66
Rate for Payer: Cofinity Advantage	$27.10
Rate for Payer: Cofinity Advantage	$36.23
Rate for Payer: Cofinity Commercial	$33.30
Rate for Payer: Cofinity Commercial	$33.99
Rate for Payer: Cofinity Commercial	$44.51
Rate for Payer: Encore Health Key Benefits Commercial	$31.62
Rate for Payer: Encore Health Key Benefits Commercial	$41.41
Rate for Payer: Encore Health Key Benefits Commercial	$30.98
Rate for Payer: Healthscope Commercial	$46.58
Rate for Payer: Healthscope Commercial	$35.57
Rate for Payer: Healthscope Commercial	$34.85
Rate for Payer: MI Amish Medical Board Commercial	$30.98
Rate for Payer: MI Amish Medical Board Commercial	$41.41
Rate for Payer: MI Amish Medical Board Commercial	$31.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$38.82
Rate for Payer: PHP Commercial	$32.91
Rate for Payer: PHP Commercial	$33.59
Rate for Payer: PHP Commercial	$44.00
Rate for Payer: Priority Health SBD	$24.39
Rate for Payer: Priority Health SBD	$32.61
Rate for Payer: Priority Health SBD	$24.90
Rate for Payer: UHC All Payor (Choice/PPO)	$0.12
Rate for Payer: UHC All Payor (Choice/PPO)	$0.12
Rate for Payer: UHC All Payor (Choice/PPO)	$0.12
Rate for Payer: UHC Core	$0.12
Rate for Payer: UHC Core	$0.12
Rate for Payer: UHC Core	$0.12
Rate for Payer: UHC Exchange	$0.12
Rate for Payer: UHC Exchange	$0.12
Rate for Payer: UHC Exchange	$0.12

NICARDIPINE 25 MG/10 ML INTRAVENOUS SOLUTION

Facility

$51.76

Service Code	HCPCS J2404
Hospital Charge Code	12370
Hospital Revenue Code	636
Min. Negotiated Rate	$32.61
Max. Negotiated Rate	$46.58
Rate for Payer: Aetna Commercial	$44.00
Rate for Payer: Aetna Commercial	$33.59
Rate for Payer: Aetna Commercial	$32.91
Rate for Payer: Aetna New Business (MI Preferred)	$25.17
Rate for Payer: Aetna New Business (MI Preferred)	$33.64
Rate for Payer: Aetna New Business (MI Preferred)	$25.69
Rate for Payer: Cash Price	$30.98
Rate for Payer: Cash Price	$31.62
Rate for Payer: Cash Price	$41.41
Rate for Payer: Cofinity Advantage	$27.66
Rate for Payer: Cofinity Advantage	$27.10
Rate for Payer: Cofinity Advantage	$36.23
Rate for Payer: Cofinity Commercial	$44.51
Rate for Payer: Cofinity Commercial	$33.30
Rate for Payer: Cofinity Commercial	$33.99
Rate for Payer: Encore Health Key Benefits Commercial	$41.41
Rate for Payer: Encore Health Key Benefits Commercial	$30.98
Rate for Payer: Encore Health Key Benefits Commercial	$31.62
Rate for Payer: Healthscope Commercial	$46.58
Rate for Payer: Healthscope Commercial	$35.57
Rate for Payer: Healthscope Commercial	$34.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$32.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$44.00
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.04
Rate for Payer: Opus (Opus Packaging Group) HMA	$29.64
Rate for Payer: Opus (Opus Packaging Group) HMA	$38.82
Rate for Payer: PHP Commercial	$33.59
Rate for Payer: PHP Commercial	$44.00
Rate for Payer: PHP Commercial	$32.91
Rate for Payer: Priority Health SBD	$24.39
Rate for Payer: Priority Health SBD	$24.90
Rate for Payer: Priority Health SBD	$32.61

Know your out-of-pocket cost for care.

All Charges