Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

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	$86.76
Rate for Payer: Cofinity Medicare Advantage	$86.76
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

$1,242.09

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

$1,052.95

Service Code	NDC 51991035860
Hospital Charge Code	99754
Hospital Revenue Code	637
Min. Negotiated Rate	$663.36
Max. Negotiated Rate	$947.66
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	$737.06
Rate for Payer: Cofinity Commercial	$905.54
Rate for Payer: Cofinity Medicare Advantage	$737.06
Rate for Payer: Encore Health Key Benefits Commercial	$842.36
Rate for Payer: Healthscope Commercial	$947.66
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

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

Facility

$940.00

Service Code	CPT 20612
Hospital Revenue Code	360
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$940.00
Rate for Payer: Aetna Medicare	$300.79
Rate for Payer: Allen County Amish Medical Aid Commercial	$361.52
Rate for Payer: Amish Plain Church Group Commercial	$361.52
Rate for Payer: BCBS Complete	$162.77
Rate for Payer: BCBS MAPPO	$289.22
Rate for Payer: BCBS Trust/PPO	$25.35
Rate for Payer: BCN Commercial	$25.35
Rate for Payer: BCN Medicare Advantage	$289.22
Rate for Payer: Health Alliance Plan Medicare Advantage	$289.22
Rate for Payer: Mclaren Medicaid	$155.02
Rate for Payer: Mclaren Medicare	$289.22
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$303.68
Rate for Payer: Meridian Medicaid	$162.77
Rate for Payer: MI Amish Medical Board Commercial	$332.60
Rate for Payer: Nomi Health Commercial	$607.36
Rate for Payer: PACE Medicare	$274.76
Rate for Payer: PACE SWMI	$289.22
Rate for Payer: PHP Medicare Advantage	$289.22
Rate for Payer: Priority Health Choice Medicaid	$155.02
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$909.03
Rate for Payer: Priority Health Medicare	$289.22
Rate for Payer: Priority Health Narrow Network	$727.22
Rate for Payer: Railroad Medicare Medicare	$289.22
Rate for Payer: UHC All Payor (Choice/PPO)	$43.55
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Dual Complete DSNP	$289.22
Rate for Payer: UHC Exchange	$940.00
Rate for Payer: UHC Medicare Advantage	$289.22
Rate for Payer: UHCCP Medicaid	$162.83
Rate for Payer: VA VA	$289.22

ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER

Facility

$6,308.24

Service Code	CPT 51102
Hospital Revenue Code	360
Min. Negotiated Rate	$150.05
Max. Negotiated Rate	$6,308.24
Rate for Payer: Aetna Medicare	$2,087.37
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,508.86
Rate for Payer: Amish Plain Church Group Commercial	$2,508.86
Rate for Payer: BCBS Complete	$1,129.59
Rate for Payer: BCBS MAPPO	$2,007.09
Rate for Payer: BCBS Trust/PPO	$826.31
Rate for Payer: BCN Commercial	$826.31
Rate for Payer: BCN Medicare Advantage	$2,007.09
Rate for Payer: Health Alliance Plan Medicare Advantage	$2,007.09
Rate for Payer: Mclaren Medicaid	$1,075.80
Rate for Payer: Mclaren Medicare	$2,007.09
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$2,107.44
Rate for Payer: Meridian Medicaid	$1,129.59
Rate for Payer: MI Amish Medical Board Commercial	$2,308.15
Rate for Payer: Nomi Health Commercial	$4,214.89
Rate for Payer: PACE Medicare	$1,906.74
Rate for Payer: PACE SWMI	$2,007.09
Rate for Payer: PHP Medicare Advantage	$2,007.09
Rate for Payer: Priority Health Choice Medicaid	$1,075.80
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$6,308.24
Rate for Payer: Priority Health Medicare	$2,007.09
Rate for Payer: Priority Health Narrow Network	$5,046.59
Rate for Payer: Railroad Medicare Medicare	$2,007.09
Rate for Payer: UHC All Payor (Choice/PPO)	$150.05
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$2,007.09
Rate for Payer: UHC Exchange	$4,450.00
Rate for Payer: UHC Medicare Advantage	$2,007.09
Rate for Payer: UHCCP Medicaid	$1,129.99
Rate for Payer: VA VA	$2,007.09

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 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 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	$19.90
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)	$353.92
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	$353.92
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)	$353.92
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	$353.92
Rate for Payer: Priority Health SBD	$343.04

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$566.50

Service Code	NDC 66553000201
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$226.60
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$481.52
Rate for Payer: Aetna Medicare	$283.25
Rate for Payer: Aetna New Business (MI Preferred)	$368.22
Rate for Payer: BCBS Complete	$226.60
Rate for Payer: Cash Price	$453.20
Rate for Payer: Cofinity Commercial	$396.55
Rate for Payer: Cofinity Commercial	$487.19
Rate for Payer: Cofinity Medicare Advantage	$396.55
Rate for Payer: Encore Health Key Benefits Commercial	$453.20
Rate for Payer: Healthscope Commercial	$509.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$481.52
Rate for Payer: PHP Commercial	$481.52
Rate for Payer: Priority Health Cigna Priority Health	$368.22
Rate for Payer: Priority Health SBD	$356.90

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

$252.00

Service Code	NDC 16103036611
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$226.80
Rate for Payer: Aetna Commercial	$214.20
Rate for Payer: Aetna Medicare	$126.00
Rate for Payer: Aetna New Business (MI Preferred)	$163.80
Rate for Payer: BCBS Complete	$100.80
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cofinity Commercial	$176.40
Rate for Payer: Cofinity Commercial	$216.72
Rate for Payer: Cofinity Medicare Advantage	$176.40
Rate for Payer: Encore Health Key Benefits Commercial	$201.60
Rate for Payer: Healthscope Commercial	$226.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$214.20
Rate for Payer: PHP Commercial	$214.20
Rate for Payer: Priority Health Cigna Priority Health	$163.80
Rate for Payer: Priority Health SBD	$158.76

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$47.63

Service Code	NDC 57896091136
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$42.87
Rate for Payer: Aetna Commercial	$40.49
Rate for Payer: Aetna Medicare	$23.82
Rate for Payer: Aetna New Business (MI Preferred)	$30.96
Rate for Payer: BCBS Complete	$19.05
Rate for Payer: Cash Price	$38.10
Rate for Payer: Cofinity Commercial	$33.34
Rate for Payer: Cofinity Commercial	$40.96
Rate for Payer: Cofinity Medicare Advantage	$33.34
Rate for Payer: Encore Health Key Benefits Commercial	$38.10
Rate for Payer: Healthscope Commercial	$42.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.49
Rate for Payer: PHP Commercial	$40.49
Rate for Payer: Priority Health Cigna Priority Health	$30.96
Rate for Payer: Priority Health SBD	$30.01

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$61.24

Service Code	NDC 00536100836
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$55.12
Rate for Payer: Aetna Commercial	$52.05
Rate for Payer: Aetna Medicare	$30.62
Rate for Payer: Aetna New Business (MI Preferred)	$39.81
Rate for Payer: BCBS Complete	$24.50
Rate for Payer: Cash Price	$48.99
Rate for Payer: Cofinity Commercial	$42.87
Rate for Payer: Cofinity Commercial	$52.67
Rate for Payer: Cofinity Medicare Advantage	$42.87
Rate for Payer: Encore Health Key Benefits Commercial	$48.99
Rate for Payer: Healthscope Commercial	$55.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.05
Rate for Payer: PHP Commercial	$52.05
Rate for Payer: Priority Health Cigna Priority Health	$39.81
Rate for Payer: Priority Health SBD	$38.58

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$566.50

Service Code	NDC 66553000201
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$356.90
Max. Negotiated Rate	$509.85
Rate for Payer: Aetna Commercial	$481.52
Rate for Payer: Aetna New Business (MI Preferred)	$368.22
Rate for Payer: Cash Price	$453.20
Rate for Payer: Cofinity Commercial	$396.55
Rate for Payer: Cofinity Commercial	$487.19
Rate for Payer: Cofinity Medicare Advantage	$396.55
Rate for Payer: Encore Health Key Benefits Commercial	$453.20
Rate for Payer: Healthscope Commercial	$509.85
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$481.52
Rate for Payer: PHP Commercial	$481.52
Rate for Payer: Priority Health Cigna Priority Health	$368.22
Rate for Payer: Priority Health SBD	$356.90

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

$252.00

Service Code	NDC 16103036611
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$158.76
Max. Negotiated Rate	$226.80
Rate for Payer: Aetna Commercial	$214.20
Rate for Payer: Aetna New Business (MI Preferred)	$163.80
Rate for Payer: Cash Price	$201.60
Rate for Payer: Cofinity Commercial	$176.40
Rate for Payer: Cofinity Commercial	$216.72
Rate for Payer: Cofinity Medicare Advantage	$176.40
Rate for Payer: Encore Health Key Benefits Commercial	$201.60
Rate for Payer: Healthscope Commercial	$226.80
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$214.20
Rate for Payer: PHP Commercial	$214.20
Rate for Payer: Priority Health Cigna Priority Health	$163.80
Rate for Payer: Priority Health SBD	$158.76

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

$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

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$61.24

Service Code	NDC 00536100836
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$38.58
Max. Negotiated Rate	$55.12
Rate for Payer: Aetna Commercial	$52.05
Rate for Payer: Aetna New Business (MI Preferred)	$39.81
Rate for Payer: Cash Price	$48.99
Rate for Payer: Cofinity Commercial	$42.87
Rate for Payer: Cofinity Commercial	$52.67
Rate for Payer: Cofinity Medicare Advantage	$42.87
Rate for Payer: Encore Health Key Benefits Commercial	$48.99
Rate for Payer: Healthscope Commercial	$55.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$52.05
Rate for Payer: PHP Commercial	$52.05
Rate for Payer: Priority Health Cigna Priority Health	$39.81
Rate for Payer: Priority Health SBD	$38.58

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

$441.00

Service Code	NDC 00904679480
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$176.40
Max. Negotiated Rate	$396.90
Rate for Payer: Aetna Commercial	$374.85
Rate for Payer: Aetna Medicare	$220.50
Rate for Payer: Aetna New Business (MI Preferred)	$286.65
Rate for Payer: BCBS Complete	$176.40
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

ASPIRIN 81 MG CHEWABLE TABLET

Facility

$47.63

Service Code	NDC 57896091136
Hospital Charge Code	679
Hospital Revenue Code	637
Min. Negotiated Rate	$30.01
Max. Negotiated Rate	$42.87
Rate for Payer: Aetna Commercial	$40.49
Rate for Payer: Aetna New Business (MI Preferred)	$30.96
Rate for Payer: Cash Price	$38.10
Rate for Payer: Cofinity Commercial	$33.34
Rate for Payer: Cofinity Commercial	$40.96
Rate for Payer: Cofinity Medicare Advantage	$33.34
Rate for Payer: Encore Health Key Benefits Commercial	$38.10
Rate for Payer: Healthscope Commercial	$42.87
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$40.49
Rate for Payer: PHP Commercial	$40.49
Rate for Payer: Priority Health Cigna Priority Health	$30.96
Rate for Payer: Priority Health SBD	$30.01

Know your out-of-pocket cost for care.

All Charges