Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$111.15

Service Code	NDC 43598044874
Hospital Charge Code	27863
Hospital Revenue Code	637
Min. Negotiated Rate	$70.02
Max. Negotiated Rate	$100.03
Rate for Payer: Aetna Commercial	$94.48
Rate for Payer: Aetna New Business (MI Preferred)	$72.25
Rate for Payer: Cash Price	$88.92
Rate for Payer: Cofinity Advantage	$77.81
Rate for Payer: Cofinity Commercial	$95.59
Rate for Payer: Encore Health Key Benefits Commercial	$88.92
Rate for Payer: Healthscope Commercial	$100.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$94.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$83.36
Rate for Payer: PHP Commercial	$94.48
Rate for Payer: Priority Health SBD	$70.02

NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$170.53

Service Code	NDC 00766142020
Hospital Charge Code	27863
Hospital Revenue Code	637
Min. Negotiated Rate	$107.43
Max. Negotiated Rate	$153.48
Rate for Payer: Aetna Commercial	$144.95
Rate for Payer: Aetna New Business (MI Preferred)	$110.84
Rate for Payer: Cash Price	$136.42
Rate for Payer: Cofinity Advantage	$119.37
Rate for Payer: Cofinity Commercial	$146.66
Rate for Payer: Encore Health Key Benefits Commercial	$136.42
Rate for Payer: Healthscope Commercial	$153.48
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$144.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$127.90
Rate for Payer: PHP Commercial	$144.95
Rate for Payer: Priority Health SBD	$107.43

NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$170.53

Service Code	NDC 00766142020
Hospital Charge Code	27863
Hospital Revenue Code	637
Min. Negotiated Rate	$67.02
Max. Negotiated Rate	$153.48
Rate for Payer: Aetna Commercial	$144.95
Rate for Payer: Aetna Medicare	$85.27
Rate for Payer: Aetna New Business (MI Preferred)	$110.84
Rate for Payer: BCBS Complete	$68.21
Rate for Payer: Cash Price	$136.42
Rate for Payer: Cofinity Advantage	$119.37
Rate for Payer: Cofinity Commercial	$146.66
Rate for Payer: Encore Health Key Benefits Commercial	$136.42
Rate for Payer: Healthscope Commercial	$153.48
Rate for Payer: MI Amish Medical Board Commercial	$136.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$144.95
Rate for Payer: Opus (Opus Packaging Group) HMA	$127.90
Rate for Payer: PHP Commercial	$144.95
Rate for Payer: Priority Health SBD	$107.43
Rate for Payer: UHC All Payor (Choice/PPO)	$110.84
Rate for Payer: UHC Core	$88.85
Rate for Payer: UHC Exchange	$67.02

NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$86.49

Service Code	NDC 00536589688
Hospital Charge Code	27863
Hospital Revenue Code	637
Min. Negotiated Rate	$54.49
Max. Negotiated Rate	$77.84
Rate for Payer: Aetna Commercial	$73.52
Rate for Payer: Aetna New Business (MI Preferred)	$56.22
Rate for Payer: Cash Price	$69.19
Rate for Payer: Cofinity Advantage	$60.54
Rate for Payer: Cofinity Commercial	$74.38
Rate for Payer: Encore Health Key Benefits Commercial	$69.19
Rate for Payer: Healthscope Commercial	$77.84
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$73.52
Rate for Payer: Opus (Opus Packaging Group) HMA	$64.87
Rate for Payer: PHP Commercial	$73.52
Rate for Payer: Priority Health SBD	$54.49

NICOTINE 21 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$121.91

Service Code	NDC 48985000152
Hospital Charge Code	27863
Hospital Revenue Code	637
Min. Negotiated Rate	$76.80
Max. Negotiated Rate	$109.72
Rate for Payer: Aetna Commercial	$103.62
Rate for Payer: Aetna New Business (MI Preferred)	$79.24
Rate for Payer: Cash Price	$97.53
Rate for Payer: Cofinity Advantage	$85.34
Rate for Payer: Cofinity Commercial	$104.84
Rate for Payer: Encore Health Key Benefits Commercial	$97.53
Rate for Payer: Healthscope Commercial	$109.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$103.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$91.43
Rate for Payer: PHP Commercial	$103.62
Rate for Payer: Priority Health SBD	$76.80

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$111.15

Service Code	NDC 43598044674
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$43.68
Max. Negotiated Rate	$100.03
Rate for Payer: Aetna Commercial	$94.48
Rate for Payer: Aetna Medicare	$55.58
Rate for Payer: Aetna New Business (MI Preferred)	$72.25
Rate for Payer: BCBS Complete	$44.46
Rate for Payer: Cash Price	$88.92
Rate for Payer: Cofinity Advantage	$77.81
Rate for Payer: Cofinity Commercial	$95.59
Rate for Payer: Encore Health Key Benefits Commercial	$88.92
Rate for Payer: Healthscope Commercial	$100.03
Rate for Payer: MI Amish Medical Board Commercial	$88.92
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$94.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$83.36
Rate for Payer: PHP Commercial	$94.48
Rate for Payer: Priority Health SBD	$70.02
Rate for Payer: UHC All Payor (Choice/PPO)	$72.25
Rate for Payer: UHC Core	$57.91
Rate for Payer: UHC Exchange	$43.68

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$7.66

Service Code	NDC 43598044671
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$6.89
Rate for Payer: Aetna Commercial	$6.51
Rate for Payer: Aetna Medicare	$3.83
Rate for Payer: Aetna New Business (MI Preferred)	$4.98
Rate for Payer: BCBS Complete	$3.06
Rate for Payer: Cash Price	$6.13
Rate for Payer: Cofinity Advantage	$5.36
Rate for Payer: Cofinity Commercial	$6.59
Rate for Payer: Encore Health Key Benefits Commercial	$6.13
Rate for Payer: Healthscope Commercial	$6.89
Rate for Payer: MI Amish Medical Board Commercial	$6.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.75
Rate for Payer: PHP Commercial	$6.51
Rate for Payer: Priority Health SBD	$4.83
Rate for Payer: UHC All Payor (Choice/PPO)	$4.98
Rate for Payer: UHC Core	$3.99
Rate for Payer: UHC Exchange	$3.01

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$65.56

Service Code	NDC 43598044670
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$55.73
Rate for Payer: Aetna Medicare	$32.78
Rate for Payer: Aetna New Business (MI Preferred)	$42.61
Rate for Payer: BCBS Complete	$26.22
Rate for Payer: Cash Price	$52.45
Rate for Payer: Cofinity Advantage	$45.89
Rate for Payer: Cofinity Commercial	$56.38
Rate for Payer: Encore Health Key Benefits Commercial	$52.45
Rate for Payer: Healthscope Commercial	$59.00
Rate for Payer: MI Amish Medical Board Commercial	$52.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$55.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$49.17
Rate for Payer: PHP Commercial	$55.73
Rate for Payer: Priority Health SBD	$41.30
Rate for Payer: UHC All Payor (Choice/PPO)	$42.61
Rate for Payer: UHC Core	$34.16
Rate for Payer: UHC Exchange	$25.77

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$111.15

Service Code	NDC 43598044674
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$70.02
Max. Negotiated Rate	$100.03
Rate for Payer: Aetna Commercial	$94.48
Rate for Payer: Aetna New Business (MI Preferred)	$72.25
Rate for Payer: Cash Price	$88.92
Rate for Payer: Cofinity Advantage	$77.81
Rate for Payer: Cofinity Commercial	$95.59
Rate for Payer: Encore Health Key Benefits Commercial	$88.92
Rate for Payer: Healthscope Commercial	$100.03
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$94.48
Rate for Payer: Opus (Opus Packaging Group) HMA	$83.36
Rate for Payer: PHP Commercial	$94.48
Rate for Payer: Priority Health SBD	$70.02

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$65.56

Service Code	NDC 43598044670
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$41.30
Max. Negotiated Rate	$59.00
Rate for Payer: Aetna Commercial	$55.73
Rate for Payer: Aetna New Business (MI Preferred)	$42.61
Rate for Payer: Cash Price	$52.45
Rate for Payer: Cofinity Advantage	$45.89
Rate for Payer: Cofinity Commercial	$56.38
Rate for Payer: Encore Health Key Benefits Commercial	$52.45
Rate for Payer: Healthscope Commercial	$59.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$55.73
Rate for Payer: Opus (Opus Packaging Group) HMA	$49.17
Rate for Payer: PHP Commercial	$55.73
Rate for Payer: Priority Health SBD	$41.30

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$7.66

Service Code	NDC 43598044671
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$6.89
Rate for Payer: Aetna Commercial	$6.51
Rate for Payer: Aetna New Business (MI Preferred)	$4.98
Rate for Payer: Cash Price	$6.13
Rate for Payer: Cofinity Advantage	$5.36
Rate for Payer: Cofinity Commercial	$6.59
Rate for Payer: Encore Health Key Benefits Commercial	$6.13
Rate for Payer: Healthscope Commercial	$6.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$6.51
Rate for Payer: Opus (Opus Packaging Group) HMA	$5.75
Rate for Payer: PHP Commercial	$6.51
Rate for Payer: Priority Health SBD	$4.83

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$107.12

Service Code	NDC 00536110688
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$67.49
Max. Negotiated Rate	$96.41
Rate for Payer: Aetna Commercial	$91.05
Rate for Payer: Aetna New Business (MI Preferred)	$69.63
Rate for Payer: Cash Price	$85.70
Rate for Payer: Cofinity Advantage	$74.98
Rate for Payer: Cofinity Commercial	$92.12
Rate for Payer: Encore Health Key Benefits Commercial	$85.70
Rate for Payer: Healthscope Commercial	$96.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$80.34
Rate for Payer: PHP Commercial	$91.05
Rate for Payer: Priority Health SBD	$67.49

NICOTINE 7 MG/24 HR DAILY TRANSDERMAL PATCH

Facility

$107.12

Service Code	NDC 00536110688
Hospital Charge Code	27860
Hospital Revenue Code	637
Min. Negotiated Rate	$42.10
Max. Negotiated Rate	$96.41
Rate for Payer: Aetna Commercial	$91.05
Rate for Payer: Aetna Medicare	$53.56
Rate for Payer: Aetna New Business (MI Preferred)	$69.63
Rate for Payer: BCBS Complete	$42.85
Rate for Payer: Cash Price	$85.70
Rate for Payer: Cofinity Advantage	$74.98
Rate for Payer: Cofinity Commercial	$92.12
Rate for Payer: Encore Health Key Benefits Commercial	$85.70
Rate for Payer: Healthscope Commercial	$96.41
Rate for Payer: MI Amish Medical Board Commercial	$85.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$91.05
Rate for Payer: Opus (Opus Packaging Group) HMA	$80.34
Rate for Payer: PHP Commercial	$91.05
Rate for Payer: Priority Health SBD	$67.49
Rate for Payer: UHC All Payor (Choice/PPO)	$69.63
Rate for Payer: UHC Core	$55.81
Rate for Payer: UHC Exchange	$42.10

NICOTINE (POLACRILEX) 2 MG BUCCAL MINI LOZENGE

Facility

$298.57

Service Code	NDC 45802008902
Hospital Charge Code	182298
Hospital Revenue Code	637
Min. Negotiated Rate	$117.34
Max. Negotiated Rate	$268.71
Rate for Payer: Aetna Commercial	$253.78
Rate for Payer: Aetna Medicare	$149.28
Rate for Payer: Aetna New Business (MI Preferred)	$194.07
Rate for Payer: BCBS Complete	$119.43
Rate for Payer: Cash Price	$238.86
Rate for Payer: Cofinity Advantage	$209.00
Rate for Payer: Cofinity Commercial	$256.77
Rate for Payer: Encore Health Key Benefits Commercial	$238.86
Rate for Payer: Healthscope Commercial	$268.71
Rate for Payer: MI Amish Medical Board Commercial	$238.86
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$253.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$223.93
Rate for Payer: PHP Commercial	$253.78
Rate for Payer: Priority Health SBD	$188.10
Rate for Payer: UHC All Payor (Choice/PPO)	$194.07
Rate for Payer: UHC Core	$155.55
Rate for Payer: UHC Exchange	$117.34

NICOTINE (POLACRILEX) 2 MG BUCCAL MINI LOZENGE

Facility

$99.53

Service Code	NDC 45802008901
Hospital Charge Code	182298
Hospital Revenue Code	637
Min. Negotiated Rate	$39.12
Max. Negotiated Rate	$89.58
Rate for Payer: Aetna Commercial	$84.60
Rate for Payer: Aetna Medicare	$49.77
Rate for Payer: Aetna New Business (MI Preferred)	$64.69
Rate for Payer: BCBS Complete	$39.81
Rate for Payer: Cash Price	$79.62
Rate for Payer: Cofinity Advantage	$69.67
Rate for Payer: Cofinity Commercial	$85.60
Rate for Payer: Encore Health Key Benefits Commercial	$79.62
Rate for Payer: Healthscope Commercial	$89.58
Rate for Payer: MI Amish Medical Board Commercial	$79.62
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$84.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$74.65
Rate for Payer: PHP Commercial	$84.60
Rate for Payer: Priority Health SBD	$62.70
Rate for Payer: UHC All Payor (Choice/PPO)	$64.69
Rate for Payer: UHC Core	$51.86
Rate for Payer: UHC Exchange	$39.12

NICOTINE (POLACRILEX) 2 MG BUCCAL MINI LOZENGE

Facility

$298.57

Service Code	NDC 45802008902
Hospital Charge Code	182298
Hospital Revenue Code	637
Min. Negotiated Rate	$188.10
Max. Negotiated Rate	$268.71
Rate for Payer: Aetna Commercial	$253.78
Rate for Payer: Aetna New Business (MI Preferred)	$194.07
Rate for Payer: Cash Price	$238.86
Rate for Payer: Cofinity Advantage	$209.00
Rate for Payer: Cofinity Commercial	$256.77
Rate for Payer: Encore Health Key Benefits Commercial	$238.86
Rate for Payer: Healthscope Commercial	$268.71
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$253.78
Rate for Payer: Opus (Opus Packaging Group) HMA	$223.93
Rate for Payer: PHP Commercial	$253.78
Rate for Payer: Priority Health SBD	$188.10

NICOTINE (POLACRILEX) 2 MG BUCCAL MINI LOZENGE

Facility

$99.53

Service Code	NDC 45802008901
Hospital Charge Code	182298
Hospital Revenue Code	637
Min. Negotiated Rate	$62.70
Max. Negotiated Rate	$89.58
Rate for Payer: Aetna Commercial	$84.60
Rate for Payer: Aetna New Business (MI Preferred)	$64.69
Rate for Payer: Cash Price	$79.62
Rate for Payer: Cofinity Advantage	$69.67
Rate for Payer: Cofinity Commercial	$85.60
Rate for Payer: Encore Health Key Benefits Commercial	$79.62
Rate for Payer: Healthscope Commercial	$89.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$84.60
Rate for Payer: Opus (Opus Packaging Group) HMA	$74.65
Rate for Payer: PHP Commercial	$84.60
Rate for Payer: Priority Health SBD	$62.70

NIFEDIPINE 10 MG CAPSULE

Facility

$336.30

Service Code	NDC 23155019401
Hospital Charge Code	5558
Hospital Revenue Code	637
Min. Negotiated Rate	$132.17
Max. Negotiated Rate	$302.67
Rate for Payer: Aetna Commercial	$285.86
Rate for Payer: Aetna Medicare	$168.15
Rate for Payer: Aetna New Business (MI Preferred)	$218.59
Rate for Payer: BCBS Complete	$134.52
Rate for Payer: Cash Price	$269.04
Rate for Payer: Cofinity Advantage	$235.41
Rate for Payer: Cofinity Commercial	$289.22
Rate for Payer: Encore Health Key Benefits Commercial	$269.04
Rate for Payer: Healthscope Commercial	$302.67
Rate for Payer: MI Amish Medical Board Commercial	$269.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$252.22
Rate for Payer: PHP Commercial	$285.86
Rate for Payer: Priority Health SBD	$211.87
Rate for Payer: UHC All Payor (Choice/PPO)	$218.59
Rate for Payer: UHC Core	$175.21
Rate for Payer: UHC Exchange	$132.17

NIFEDIPINE 10 MG CAPSULE

Facility

$336.30

Service Code	NDC 23155019401
Hospital Charge Code	5558
Hospital Revenue Code	637
Min. Negotiated Rate	$211.87
Max. Negotiated Rate	$302.67
Rate for Payer: Aetna Commercial	$285.86
Rate for Payer: Aetna New Business (MI Preferred)	$218.59
Rate for Payer: Cash Price	$269.04
Rate for Payer: Cofinity Advantage	$235.41
Rate for Payer: Cofinity Commercial	$289.22
Rate for Payer: Encore Health Key Benefits Commercial	$269.04
Rate for Payer: Healthscope Commercial	$302.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$285.86
Rate for Payer: Opus (Opus Packaging Group) HMA	$252.22
Rate for Payer: PHP Commercial	$285.86
Rate for Payer: Priority Health SBD	$211.87

NIFEDIPINE 10 MG CAPSULE

Facility

$430.56

Service Code	NDC 00904722961
Hospital Charge Code	5558
Hospital Revenue Code	637
Min. Negotiated Rate	$169.21
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$365.98
Rate for Payer: Aetna Medicare	$215.28
Rate for Payer: Aetna New Business (MI Preferred)	$279.86
Rate for Payer: BCBS Complete	$172.22
Rate for Payer: Cash Price	$344.45
Rate for Payer: Cofinity Advantage	$301.39
Rate for Payer: Cofinity Commercial	$370.28
Rate for Payer: Encore Health Key Benefits Commercial	$344.45
Rate for Payer: Healthscope Commercial	$387.50
Rate for Payer: MI Amish Medical Board Commercial	$344.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$322.92
Rate for Payer: PHP Commercial	$365.98
Rate for Payer: Priority Health SBD	$271.25
Rate for Payer: UHC All Payor (Choice/PPO)	$279.86
Rate for Payer: UHC Core	$224.32
Rate for Payer: UHC Exchange	$169.21

NIFEDIPINE 10 MG CAPSULE

Facility

$430.56

Service Code	NDC 00904722961
Hospital Charge Code	5558
Hospital Revenue Code	637
Min. Negotiated Rate	$271.25
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$365.98
Rate for Payer: Aetna New Business (MI Preferred)	$279.86
Rate for Payer: Cash Price	$344.45
Rate for Payer: Cofinity Advantage	$301.39
Rate for Payer: Cofinity Commercial	$370.28
Rate for Payer: Encore Health Key Benefits Commercial	$344.45
Rate for Payer: Healthscope Commercial	$387.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$322.92
Rate for Payer: PHP Commercial	$365.98
Rate for Payer: Priority Health SBD	$271.25

NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$467.04

Service Code	NDC 68084059701
Hospital Charge Code	27333
Hospital Revenue Code	637
Min. Negotiated Rate	$183.55
Max. Negotiated Rate	$420.34
Rate for Payer: Aetna Commercial	$396.98
Rate for Payer: Aetna Medicare	$233.52
Rate for Payer: Aetna New Business (MI Preferred)	$303.58
Rate for Payer: BCBS Complete	$186.82
Rate for Payer: Cash Price	$373.63
Rate for Payer: Cofinity Advantage	$326.93
Rate for Payer: Cofinity Commercial	$401.65
Rate for Payer: Encore Health Key Benefits Commercial	$373.63
Rate for Payer: Healthscope Commercial	$420.34
Rate for Payer: MI Amish Medical Board Commercial	$373.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$396.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$350.28
Rate for Payer: PHP Commercial	$396.98
Rate for Payer: Priority Health SBD	$294.24
Rate for Payer: UHC All Payor (Choice/PPO)	$303.58
Rate for Payer: UHC Core	$243.33
Rate for Payer: UHC Exchange	$183.55

NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.68

Service Code	NDC 68084059711
Hospital Charge Code	27333
Hospital Revenue Code	637
Min. Negotiated Rate	$1.84
Max. Negotiated Rate	$4.21
Rate for Payer: Aetna Commercial	$3.98
Rate for Payer: Aetna Medicare	$2.34
Rate for Payer: Aetna New Business (MI Preferred)	$3.04
Rate for Payer: BCBS Complete	$1.87
Rate for Payer: Cash Price	$3.74
Rate for Payer: Cofinity Advantage	$3.28
Rate for Payer: Cofinity Commercial	$4.02
Rate for Payer: Encore Health Key Benefits Commercial	$3.74
Rate for Payer: Healthscope Commercial	$4.21
Rate for Payer: MI Amish Medical Board Commercial	$3.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.51
Rate for Payer: PHP Commercial	$3.98
Rate for Payer: Priority Health SBD	$2.95
Rate for Payer: UHC All Payor (Choice/PPO)	$3.04
Rate for Payer: UHC Core	$2.44
Rate for Payer: UHC Exchange	$1.84

NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$4.68

Service Code	NDC 68084059711
Hospital Charge Code	27333
Hospital Revenue Code	637
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$4.21
Rate for Payer: Aetna Commercial	$3.98
Rate for Payer: Aetna New Business (MI Preferred)	$3.04
Rate for Payer: Cash Price	$3.74
Rate for Payer: Cofinity Advantage	$3.28
Rate for Payer: Cofinity Commercial	$4.02
Rate for Payer: Encore Health Key Benefits Commercial	$3.74
Rate for Payer: Healthscope Commercial	$4.21
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$3.51
Rate for Payer: PHP Commercial	$3.98
Rate for Payer: Priority Health SBD	$2.95

NIFEDIPINE ER 30 MG TABLET,EXTENDED RELEASE 24 HR

Facility

$467.04

Service Code	NDC 68084059701
Hospital Charge Code	27333
Hospital Revenue Code	637
Min. Negotiated Rate	$294.24
Max. Negotiated Rate	$420.34
Rate for Payer: Aetna Commercial	$396.98
Rate for Payer: Aetna New Business (MI Preferred)	$303.58
Rate for Payer: Cash Price	$373.63
Rate for Payer: Cofinity Advantage	$326.93
Rate for Payer: Cofinity Commercial	$401.65
Rate for Payer: Encore Health Key Benefits Commercial	$373.63
Rate for Payer: Healthscope Commercial	$420.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$396.98
Rate for Payer: Opus (Opus Packaging Group) HMA	$350.28
Rate for Payer: PHP Commercial	$396.98
Rate for Payer: Priority Health SBD	$294.24

Know your out-of-pocket cost for care.

All Charges