Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ASCORBIC ACID (VITAMIN C) 500 MG TABLET

Facility

$110.45

Service Code	NDC 79854030035
Hospital Charge Code	664
Hospital Revenue Code	637
Min. Negotiated Rate	$69.58
Max. Negotiated Rate	$99.41
Rate for Payer: Aetna Commercial	$93.88
Rate for Payer: Aetna New Business (MI Preferred)	$71.79
Rate for Payer: Cash Price	$88.36
Rate for Payer: Cofinity Commercial	$77.31
Rate for Payer: Cofinity Commercial	$94.99
Rate for Payer: Cofinity Medicare Advantage	$77.31
Rate for Payer: Encore Health Key Benefits Commercial	$88.36
Rate for Payer: Healthscope Commercial	$99.41
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$93.88
Rate for Payer: PHP Commercial	$93.88
Rate for Payer: Priority Health Cigna Priority Health	$71.79
Rate for Payer: Priority Health SBD	$69.58

ASCORBIC ACID (VITAMIN C) 500 MG TABLET

Facility

$70.50

Service Code	NDC 00904052361
Hospital Charge Code	664
Hospital Revenue Code	637
Min. Negotiated Rate	$44.41
Max. Negotiated Rate	$63.45
Rate for Payer: Aetna Commercial	$59.92
Rate for Payer: Aetna New Business (MI Preferred)	$45.83
Rate for Payer: Cash Price	$56.40
Rate for Payer: Cofinity Commercial	$49.35
Rate for Payer: Cofinity Commercial	$60.63
Rate for Payer: Cofinity Medicare Advantage	$49.35
Rate for Payer: Encore Health Key Benefits Commercial	$56.40
Rate for Payer: Healthscope Commercial	$63.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$59.92
Rate for Payer: PHP Commercial	$59.92
Rate for Payer: Priority Health Cigna Priority Health	$45.83
Rate for Payer: Priority Health SBD	$44.41

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$207.02

Service Code	NDC 59762201201
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$130.42
Max. Negotiated Rate	$186.32
Rate for Payer: Aetna Commercial	$175.97
Rate for Payer: Aetna New Business (MI Preferred)	$134.56
Rate for Payer: Cash Price	$165.62
Rate for Payer: Cofinity Commercial	$144.91
Rate for Payer: Cofinity Commercial	$178.04
Rate for Payer: Cofinity Medicare Advantage	$144.91
Rate for Payer: Encore Health Key Benefits Commercial	$165.62
Rate for Payer: Healthscope Commercial	$186.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.97
Rate for Payer: PHP Commercial	$175.97
Rate for Payer: Priority Health Cigna Priority Health	$134.56
Rate for Payer: Priority Health SBD	$130.42

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$123.95

Service Code	NDC 62332019810
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$49.58
Max. Negotiated Rate	$111.56
Rate for Payer: Aetna Commercial	$105.36
Rate for Payer: Aetna Medicare	$61.98
Rate for Payer: Aetna New Business (MI Preferred)	$80.57
Rate for Payer: BCBS Complete	$49.58
Rate for Payer: Cash Price	$99.16
Rate for Payer: Cofinity Commercial	$106.60
Rate for Payer: Cofinity Commercial	$86.77
Rate for Payer: Cofinity Medicare Advantage	$86.77
Rate for Payer: Encore Health Key Benefits Commercial	$99.16
Rate for Payer: Healthscope Commercial	$111.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.36
Rate for Payer: PHP Commercial	$105.36
Rate for Payer: Priority Health Cigna Priority Health	$80.57
Rate for Payer: Priority Health SBD	$78.09

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,239.50

Service Code	NDC 62332019831
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$780.88
Max. Negotiated Rate	$1,115.55
Rate for Payer: Aetna Commercial	$1,053.58
Rate for Payer: Aetna New Business (MI Preferred)	$805.67
Rate for Payer: Cash Price	$991.60
Rate for Payer: Cofinity Commercial	$1,065.97
Rate for Payer: Cofinity Commercial	$867.65
Rate for Payer: Cofinity Medicare Advantage	$867.65
Rate for Payer: Encore Health Key Benefits Commercial	$991.60
Rate for Payer: Healthscope Commercial	$1,115.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,053.58
Rate for Payer: PHP Commercial	$1,053.58
Rate for Payer: Priority Health Cigna Priority Health	$805.67
Rate for Payer: Priority Health SBD	$780.88

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,242.09

Service Code	NDC 59762201206
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$782.52
Max. Negotiated Rate	$1,117.88
Rate for Payer: Aetna Commercial	$1,055.78
Rate for Payer: Aetna New Business (MI Preferred)	$807.36
Rate for Payer: Cash Price	$993.67
Rate for Payer: Cofinity Commercial	$1,068.20
Rate for Payer: Cofinity Commercial	$869.46
Rate for Payer: Cofinity Medicare Advantage	$869.46
Rate for Payer: Encore Health Key Benefits Commercial	$993.67
Rate for Payer: Healthscope Commercial	$1,117.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,055.78
Rate for Payer: PHP Commercial	$1,055.78
Rate for Payer: Priority Health Cigna Priority Health	$807.36
Rate for Payer: Priority Health SBD	$782.52

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,242.09

Service Code	NDC 59762201206
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$496.84
Max. Negotiated Rate	$1,117.88
Rate for Payer: Aetna Commercial	$1,055.78
Rate for Payer: Aetna Medicare	$621.04
Rate for Payer: Aetna New Business (MI Preferred)	$807.36
Rate for Payer: BCBS Complete	$496.84
Rate for Payer: Cash Price	$993.67
Rate for Payer: Cofinity Commercial	$1,068.20
Rate for Payer: Cofinity Commercial	$869.46
Rate for Payer: Cofinity Medicare Advantage	$869.46
Rate for Payer: Encore Health Key Benefits Commercial	$993.67
Rate for Payer: Healthscope Commercial	$1,117.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,055.78
Rate for Payer: PHP Commercial	$1,055.78
Rate for Payer: Priority Health Cigna Priority Health	$807.36
Rate for Payer: Priority Health SBD	$782.52

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$123.95

Service Code	NDC 62332019810
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$78.09
Max. Negotiated Rate	$111.56
Rate for Payer: Aetna Commercial	$105.36
Rate for Payer: Aetna New Business (MI Preferred)	$80.57
Rate for Payer: Cash Price	$99.16
Rate for Payer: Cofinity Commercial	$106.60
Rate for Payer: Cofinity Commercial	$86.77
Rate for Payer: Cofinity Medicare Advantage	$86.77
Rate for Payer: Encore Health Key Benefits Commercial	$99.16
Rate for Payer: Healthscope Commercial	$111.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.36
Rate for Payer: PHP Commercial	$105.36
Rate for Payer: Priority Health Cigna Priority Health	$80.57
Rate for Payer: Priority Health SBD	$78.09

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,052.95

Service Code	NDC 51991035860
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$663.36
Max. Negotiated Rate	$947.65
Rate for Payer: Aetna Commercial	$895.01
Rate for Payer: Aetna New Business (MI Preferred)	$684.42
Rate for Payer: Cash Price	$842.36
Rate for Payer: Cofinity Commercial	$737.07
Rate for Payer: Cofinity Commercial	$905.54
Rate for Payer: Cofinity Medicare Advantage	$737.07
Rate for Payer: Encore Health Key Benefits Commercial	$842.36
Rate for Payer: Healthscope Commercial	$947.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$895.01
Rate for Payer: PHP Commercial	$895.01
Rate for Payer: Priority Health Cigna Priority Health	$684.42
Rate for Payer: Priority Health SBD	$663.36

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,052.95

Service Code	NDC 51991035860
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$421.18
Max. Negotiated Rate	$947.65
Rate for Payer: Aetna Commercial	$895.01
Rate for Payer: Aetna Medicare	$526.48
Rate for Payer: Aetna New Business (MI Preferred)	$684.42
Rate for Payer: BCBS Complete	$421.18
Rate for Payer: Cash Price	$842.36
Rate for Payer: Cofinity Commercial	$737.07
Rate for Payer: Cofinity Commercial	$905.54
Rate for Payer: Cofinity Medicare Advantage	$737.07
Rate for Payer: Encore Health Key Benefits Commercial	$842.36
Rate for Payer: Healthscope Commercial	$947.65
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$895.01
Rate for Payer: PHP Commercial	$895.01
Rate for Payer: Priority Health Cigna Priority Health	$684.42
Rate for Payer: Priority Health SBD	$663.36

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$1,239.50

Service Code	NDC 62332019831
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$495.80
Max. Negotiated Rate	$1,115.55
Rate for Payer: Aetna Commercial	$1,053.58
Rate for Payer: Aetna Medicare	$619.75
Rate for Payer: Aetna New Business (MI Preferred)	$805.67
Rate for Payer: BCBS Complete	$495.80
Rate for Payer: Cash Price	$991.60
Rate for Payer: Cofinity Commercial	$1,065.97
Rate for Payer: Cofinity Commercial	$867.65
Rate for Payer: Cofinity Medicare Advantage	$867.65
Rate for Payer: Encore Health Key Benefits Commercial	$991.60
Rate for Payer: Healthscope Commercial	$1,115.55
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,053.58
Rate for Payer: PHP Commercial	$1,053.58
Rate for Payer: Priority Health Cigna Priority Health	$805.67
Rate for Payer: Priority Health SBD	$780.88

ASENAPINE 5 MG SUBLINGUAL TABLET

Facility

$207.02

Service Code	NDC 59762201201
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$82.81
Max. Negotiated Rate	$186.32
Rate for Payer: Aetna Commercial	$175.97
Rate for Payer: Aetna Medicare	$103.51
Rate for Payer: Aetna New Business (MI Preferred)	$134.56
Rate for Payer: BCBS Complete	$82.81
Rate for Payer: Cash Price	$165.62
Rate for Payer: Cofinity Commercial	$144.91
Rate for Payer: Cofinity Commercial	$178.04
Rate for Payer: Cofinity Medicare Advantage	$144.91
Rate for Payer: Encore Health Key Benefits Commercial	$165.62
Rate for Payer: Healthscope Commercial	$186.32
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$175.97
Rate for Payer: PHP Commercial	$175.97
Rate for Payer: Priority Health Cigna Priority Health	$134.56
Rate for Payer: Priority Health SBD	$130.42

ASPIRATION AND/OR INJECTION OF GANGLION CYST(S) ANY LOCATION

Facility

$810.38

Service Code	CPT 20612
Hospital Revenue Code	360
Min. Negotiated Rate	$154.31
Max. Negotiated Rate	$810.38
Rate for Payer: Aetna Medicare	$299.41
Rate for Payer: Allen County Amish Medical Aid Commercial	$359.86
Rate for Payer: Amish Plain Church Group Commercial	$359.86
Rate for Payer: BCBS Complete	$162.02
Rate for Payer: BCBS MAPPO	$287.89
Rate for Payer: BCN Medicare Advantage	$287.89
Rate for Payer: Health Alliance Plan Medicare Advantage	$287.89
Rate for Payer: Mclaren Medicaid	$154.31
Rate for Payer: Mclaren Medicare	$287.89
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$302.28
Rate for Payer: Meridian Medicaid	$162.02
Rate for Payer: MI Amish Medical Board Commercial	$331.07
Rate for Payer: PACE Medicare	$273.50
Rate for Payer: PACE SWMI	$287.89
Rate for Payer: PHP Medicare Advantage	$287.89
Rate for Payer: Priority Health Choice Medicaid	$154.31
Rate for Payer: Priority Health Medicare	$287.89
Rate for Payer: Railroad Medicare Medicare	$287.89
Rate for Payer: UHC All Payor (Choice/PPO)	$810.38
Rate for Payer: UHC Dual Complete DSNP	$287.89
Rate for Payer: UHC Medicare Advantage	$287.89
Rate for Payer: UHCCP Medicaid	$162.08
Rate for Payer: VA VA	$287.89

ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER

Facility

$5,623.80

Service Code	CPT 51102
Hospital Revenue Code	360
Min. Negotiated Rate	$1,070.86
Max. Negotiated Rate	$5,623.80
Rate for Payer: Aetna Medicare	$2,077.78
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,497.34
Rate for Payer: Amish Plain Church Group Commercial	$2,497.34
Rate for Payer: BCBS Complete	$1,124.40
Rate for Payer: BCBS MAPPO	$1,997.87
Rate for Payer: BCN Medicare Advantage	$1,997.87
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,997.87
Rate for Payer: Mclaren Medicaid	$1,070.86
Rate for Payer: Mclaren Medicare	$1,997.87
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,097.76
Rate for Payer: Meridian Medicaid	$1,124.40
Rate for Payer: MI Amish Medical Board Commercial	$2,297.55
Rate for Payer: PACE Medicare	$1,897.98
Rate for Payer: PACE SWMI	$1,997.87
Rate for Payer: PHP Medicare Advantage	$1,997.87
Rate for Payer: Priority Health Choice Medicaid	$1,070.86
Rate for Payer: Priority Health Medicare	$1,997.87
Rate for Payer: Railroad Medicare Medicare	$1,997.87
Rate for Payer: UHC All Payor (Choice/PPO)	$5,623.80
Rate for Payer: UHC Dual Complete DSNP	$1,997.87
Rate for Payer: UHC Medicare Advantage	$1,997.87
Rate for Payer: UHCCP Medicaid	$1,124.80
Rate for Payer: VA VA	$1,997.87

ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE

Facility

$215.14

Service Code	NDC 68462040560
Hospital Charge Code	27644
Hospital Revenue Code	637
Min. Negotiated Rate	$86.06
Max. Negotiated Rate	$193.63
Rate for Payer: Aetna Commercial	$182.87
Rate for Payer: Aetna Medicare	$107.57
Rate for Payer: Aetna New Business (MI Preferred)	$139.84
Rate for Payer: BCBS Complete	$86.06
Rate for Payer: Cash Price	$172.11
Rate for Payer: Cofinity Commercial	$150.60
Rate for Payer: Cofinity Commercial	$185.02
Rate for Payer: Cofinity Medicare Advantage	$150.60
Rate for Payer: Encore Health Key Benefits Commercial	$172.11
Rate for Payer: Healthscope Commercial	$193.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.87
Rate for Payer: PHP Commercial	$182.87
Rate for Payer: Priority Health Cigna Priority Health	$139.84
Rate for Payer: Priority Health SBD	$135.54

ASPIRIN 25 MG-DIPYRIDAMOLE 200 MG CAPSULE,EXT.RELEASE 12 HR MULTIPHASE

Facility

$215.14

Service Code	NDC 68462040560
Hospital Charge Code	27644
Hospital Revenue Code	637
Min. Negotiated Rate	$135.54
Max. Negotiated Rate	$193.63
Rate for Payer: Aetna Commercial	$182.87
Rate for Payer: Aetna New Business (MI Preferred)	$139.84
Rate for Payer: Cash Price	$172.11
Rate for Payer: Cofinity Commercial	$150.60
Rate for Payer: Cofinity Commercial	$185.02
Rate for Payer: Cofinity Medicare Advantage	$150.60
Rate for Payer: Encore Health Key Benefits Commercial	$172.11
Rate for Payer: Healthscope Commercial	$193.63
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.87
Rate for Payer: PHP Commercial	$182.87
Rate for Payer: Priority Health Cigna Priority Health	$139.84
Rate for Payer: Priority Health SBD	$135.54

ASPIRIN 300 MG RECTAL SUPPOSITORY

Facility

$39.79

Service Code	NDC 00574703412
Hospital Charge Code	693
Hospital Revenue Code	637
Min. Negotiated Rate	$15.92
Max. Negotiated Rate	$35.81
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna Medicare	$19.89
Rate for Payer: Aetna New Business (MI Preferred)	$25.86
Rate for Payer: BCBS Complete	$15.92
Rate for Payer: Cash Price	$31.83
Rate for Payer: Cofinity Commercial	$27.85
Rate for Payer: Cofinity Commercial	$34.22
Rate for Payer: Cofinity Medicare Advantage	$27.85
Rate for Payer: Encore Health Key Benefits Commercial	$31.83
Rate for Payer: Healthscope Commercial	$35.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.82
Rate for Payer: PHP Commercial	$33.82
Rate for Payer: Priority Health Cigna Priority Health	$25.86
Rate for Payer: Priority Health SBD	$25.07

ASPIRIN 300 MG RECTAL SUPPOSITORY

Facility

$39.79

Service Code	NDC 00574703412
Hospital Charge Code	693
Hospital Revenue Code	637
Min. Negotiated Rate	$25.07
Max. Negotiated Rate	$35.81
Rate for Payer: Aetna Commercial	$33.82
Rate for Payer: Aetna New Business (MI Preferred)	$25.86
Rate for Payer: Cash Price	$31.83
Rate for Payer: Cofinity Commercial	$27.85
Rate for Payer: Cofinity Commercial	$34.22
Rate for Payer: Cofinity Medicare Advantage	$27.85
Rate for Payer: Encore Health Key Benefits Commercial	$31.83
Rate for Payer: Healthscope Commercial	$35.81
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$33.82
Rate for Payer: PHP Commercial	$33.82
Rate for Payer: Priority Health Cigna Priority Health	$25.86
Rate for Payer: Priority Health SBD	$25.07

ASPIRIN 325 MG TABLET

Facility

$544.50

Service Code	NDC 66553000101
Hospital Charge Code	681
Hospital Revenue Code	637
Min. Negotiated Rate	$343.04
Max. Negotiated Rate	$490.05
Rate for Payer: Aetna Commercial	$462.82
Rate for Payer: Aetna New Business (MI Preferred)	$353.93
Rate for Payer: Cash Price	$435.60
Rate for Payer: Cofinity Commercial	$381.15
Rate for Payer: Cofinity Commercial	$468.27
Rate for Payer: Cofinity Medicare Advantage	$381.15
Rate for Payer: Encore Health Key Benefits Commercial	$435.60
Rate for Payer: Healthscope Commercial	$490.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$462.82
Rate for Payer: PHP Commercial	$462.82
Rate for Payer: Priority Health Cigna Priority Health	$353.93
Rate for Payer: Priority Health SBD	$343.04

ASPIRIN 325 MG TABLET

Facility

$544.50

Service Code	NDC 66553000101
Hospital Charge Code	681
Hospital Revenue Code	637
Min. Negotiated Rate	$217.80
Max. Negotiated Rate	$490.05
Rate for Payer: Aetna Commercial	$462.82
Rate for Payer: Aetna Medicare	$272.25
Rate for Payer: Aetna New Business (MI Preferred)	$353.93
Rate for Payer: BCBS Complete	$217.80
Rate for Payer: Cash Price	$435.60
Rate for Payer: Cofinity Commercial	$381.15
Rate for Payer: Cofinity Commercial	$468.27
Rate for Payer: Cofinity Medicare Advantage	$381.15
Rate for Payer: Encore Health Key Benefits Commercial	$435.60
Rate for Payer: Healthscope Commercial	$490.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$462.82
Rate for Payer: PHP Commercial	$462.82
Rate for Payer: Priority Health Cigna Priority Health	$353.93
Rate for Payer: Priority Health SBD	$343.04

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$756.00

Service Code	NDC 63739043402
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$476.28
Max. Negotiated Rate	$680.40
Rate for Payer: Aetna Commercial	$642.60
Rate for Payer: Aetna New Business (MI Preferred)	$491.40
Rate for Payer: Cash Price	$604.80
Rate for Payer: Cofinity Commercial	$529.20
Rate for Payer: Cofinity Commercial	$650.16
Rate for Payer: Cofinity Medicare Advantage	$529.20
Rate for Payer: Encore Health Key Benefits Commercial	$604.80
Rate for Payer: Healthscope Commercial	$680.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$642.60
Rate for Payer: PHP Commercial	$642.60
Rate for Payer: Priority Health Cigna Priority Health	$491.40
Rate for Payer: Priority Health SBD	$476.28

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$756.00

Service Code	NDC 63739043402
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$302.40
Max. Negotiated Rate	$680.40
Rate for Payer: Aetna Commercial	$642.60
Rate for Payer: Aetna Medicare	$378.00
Rate for Payer: Aetna New Business (MI Preferred)	$491.40
Rate for Payer: BCBS Complete	$302.40
Rate for Payer: Cash Price	$604.80
Rate for Payer: Cofinity Commercial	$529.20
Rate for Payer: Cofinity Commercial	$650.16
Rate for Payer: Cofinity Medicare Advantage	$529.20
Rate for Payer: Encore Health Key Benefits Commercial	$604.80
Rate for Payer: Healthscope Commercial	$680.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$642.60
Rate for Payer: PHP Commercial	$642.60
Rate for Payer: Priority Health Cigna Priority Health	$491.40
Rate for Payer: Priority Health SBD	$476.28

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$684.00

Service Code	NDC 00904679430
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$273.60
Max. Negotiated Rate	$615.60
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare	$342.00
Rate for Payer: Aetna New Business (MI Preferred)	$444.60
Rate for Payer: BCBS Complete	$273.60
Rate for Payer: Cash Price	$547.20
Rate for Payer: Cofinity Commercial	$478.80
Rate for Payer: Cofinity Commercial	$588.24
Rate for Payer: Cofinity Medicare Advantage	$478.80
Rate for Payer: Encore Health Key Benefits Commercial	$547.20
Rate for Payer: Healthscope Commercial	$615.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$581.40
Rate for Payer: PHP Commercial	$581.40
Rate for Payer: Priority Health Cigna Priority Health	$444.60
Rate for Payer: Priority Health SBD	$430.92

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$684.00

Service Code	NDC 00904679430
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$430.92
Max. Negotiated Rate	$615.60
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna New Business (MI Preferred)	$444.60
Rate for Payer: Cash Price	$547.20
Rate for Payer: Cofinity Commercial	$478.80
Rate for Payer: Cofinity Commercial	$588.24
Rate for Payer: Cofinity Medicare Advantage	$478.80
Rate for Payer: Encore Health Key Benefits Commercial	$547.20
Rate for Payer: Healthscope Commercial	$615.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$581.40
Rate for Payer: PHP Commercial	$581.40
Rate for Payer: Priority Health Cigna Priority Health	$444.60
Rate for Payer: Priority Health SBD	$430.92

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$441.00

Service Code	NDC 00904679480
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna Commercial	$374.85
Rate for Payer: Aetna New Business (MI Preferred)	$286.65
Rate for Payer: Cash Price	$352.80
Rate for Payer: Cofinity Commercial	$308.70
Rate for Payer: Cofinity Commercial	$379.26
Rate for Payer: Cofinity Medicare Advantage	$308.70
Rate for Payer: Encore Health Key Benefits Commercial	$352.80
Rate for Payer: Healthscope Commercial	$396.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$374.85
Rate for Payer: PHP Commercial	$374.85
Rate for Payer: Priority Health Cigna Priority Health	$286.65
Rate for Payer: Priority Health SBD	$277.83

Know your out-of-pocket cost for care.

All Charges