Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 96295012960
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna Medicare	$23.41
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: BCBS Complete	$18.73
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Cofinity Medicare Advantage	$32.77
Rate for Payer: Encore Health Key Benefits Commercial	$37.46
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$30.43
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$4.85

Service Code	NDC 47682022864
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$4.12
Rate for Payer: Aetna Medicare	$2.42
Rate for Payer: Aetna New Business (MI Preferred)	$3.15
Rate for Payer: BCBS Complete	$1.94
Rate for Payer: Cash Price	$3.88
Rate for Payer: Cofinity Commercial	$3.40
Rate for Payer: Cofinity Commercial	$4.17
Rate for Payer: Cofinity Medicare Advantage	$3.40
Rate for Payer: Encore Health Key Benefits Commercial	$3.88
Rate for Payer: Healthscope Commercial	$4.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.12
Rate for Payer: PHP Commercial	$4.12
Rate for Payer: Priority Health Cigna Priority Health	$3.15
Rate for Payer: Priority Health SBD	$3.06

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$44.65

Service Code	NDC 00904513559
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$40.18
Rate for Payer: Aetna Commercial	$37.95
Rate for Payer: Aetna New Business (MI Preferred)	$29.02
Rate for Payer: Cash Price	$35.72
Rate for Payer: Cofinity Commercial	$31.26
Rate for Payer: Cofinity Commercial	$38.40
Rate for Payer: Cofinity Medicare Advantage	$31.26
Rate for Payer: Encore Health Key Benefits Commercial	$35.72
Rate for Payer: Healthscope Commercial	$40.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.95
Rate for Payer: PHP Commercial	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$29.02
Rate for Payer: Priority Health SBD	$28.13

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$58.75

Service Code	NDC 00536132601
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$37.01
Max. Negotiated Rate	$52.88
Rate for Payer: Aetna Commercial	$49.94
Rate for Payer: Aetna New Business (MI Preferred)	$38.19
Rate for Payer: Cash Price	$47.00
Rate for Payer: Cofinity Commercial	$41.12
Rate for Payer: Cofinity Commercial	$50.52
Rate for Payer: Cofinity Medicare Advantage	$41.12
Rate for Payer: Encore Health Key Benefits Commercial	$47.00
Rate for Payer: Healthscope Commercial	$52.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.94
Rate for Payer: PHP Commercial	$49.94
Rate for Payer: Priority Health Cigna Priority Health	$38.19
Rate for Payer: Priority Health SBD	$37.01

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 70000014601
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$29.50
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Cofinity Medicare Advantage	$32.77
Rate for Payer: Encore Health Key Benefits Commercial	$37.46
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$30.43
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 96295012960
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$29.50
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Cofinity Medicare Advantage	$32.77
Rate for Payer: Encore Health Key Benefits Commercial	$37.46
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$30.43
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$44.65

Service Code	NDC 00904513559
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$17.86
Max. Negotiated Rate	$40.18
Rate for Payer: Aetna Commercial	$37.95
Rate for Payer: Aetna Medicare	$22.32
Rate for Payer: Aetna New Business (MI Preferred)	$29.02
Rate for Payer: BCBS Complete	$17.86
Rate for Payer: Cash Price	$35.72
Rate for Payer: Cofinity Commercial	$31.26
Rate for Payer: Cofinity Commercial	$38.40
Rate for Payer: Cofinity Medicare Advantage	$31.26
Rate for Payer: Encore Health Key Benefits Commercial	$35.72
Rate for Payer: Healthscope Commercial	$40.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$37.95
Rate for Payer: PHP Commercial	$37.95
Rate for Payer: Priority Health Cigna Priority Health	$29.02
Rate for Payer: Priority Health SBD	$28.13

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$4.85

Service Code	NDC 47682022864
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$4.36
Rate for Payer: Aetna Commercial	$4.12
Rate for Payer: Aetna New Business (MI Preferred)	$3.15
Rate for Payer: Cash Price	$3.88
Rate for Payer: Cofinity Commercial	$3.40
Rate for Payer: Cofinity Commercial	$4.17
Rate for Payer: Cofinity Medicare Advantage	$3.40
Rate for Payer: Encore Health Key Benefits Commercial	$3.88
Rate for Payer: Healthscope Commercial	$4.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.12
Rate for Payer: PHP Commercial	$4.12
Rate for Payer: Priority Health Cigna Priority Health	$3.15
Rate for Payer: Priority Health SBD	$3.06

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$46.82

Service Code	NDC 70000014601
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$42.14
Rate for Payer: Aetna Commercial	$39.80
Rate for Payer: Aetna Medicare	$23.41
Rate for Payer: Aetna New Business (MI Preferred)	$30.43
Rate for Payer: BCBS Complete	$18.73
Rate for Payer: Cash Price	$37.46
Rate for Payer: Cofinity Commercial	$32.77
Rate for Payer: Cofinity Commercial	$40.27
Rate for Payer: Cofinity Medicare Advantage	$32.77
Rate for Payer: Encore Health Key Benefits Commercial	$37.46
Rate for Payer: Healthscope Commercial	$42.14
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$39.80
Rate for Payer: PHP Commercial	$39.80
Rate for Payer: Priority Health Cigna Priority Health	$30.43
Rate for Payer: Priority Health SBD	$29.50

ASPIRIN-ACETAMINOPHEN-CAFFEINE 250 MG-250 MG-65 MG TABLET

Facility

$58.75

Service Code	NDC 00536132601
Hospital Charge Code	9158
Hospital Revenue Code	637
Min. Negotiated Rate	$23.50
Max. Negotiated Rate	$52.88
Rate for Payer: Aetna Commercial	$49.94
Rate for Payer: Aetna Medicare	$29.38
Rate for Payer: Aetna New Business (MI Preferred)	$38.19
Rate for Payer: BCBS Complete	$23.50
Rate for Payer: Cash Price	$47.00
Rate for Payer: Cofinity Commercial	$41.12
Rate for Payer: Cofinity Commercial	$50.52
Rate for Payer: Cofinity Medicare Advantage	$41.12
Rate for Payer: Encore Health Key Benefits Commercial	$47.00
Rate for Payer: Healthscope Commercial	$52.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.94
Rate for Payer: PHP Commercial	$49.94
Rate for Payer: Priority Health Cigna Priority Health	$38.19
Rate for Payer: Priority Health SBD	$37.01

ATENOLOL 25 MG TABLET

Facility

$4.31

Service Code	NDC 51079075901
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$3.88
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna New Business (MI Preferred)	$2.80
Rate for Payer: Cash Price	$3.45
Rate for Payer: Cofinity Commercial	$3.02
Rate for Payer: Cofinity Commercial	$3.71
Rate for Payer: Cofinity Medicare Advantage	$3.02
Rate for Payer: Encore Health Key Benefits Commercial	$3.45
Rate for Payer: Healthscope Commercial	$3.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.66
Rate for Payer: PHP Commercial	$3.66
Rate for Payer: Priority Health Cigna Priority Health	$2.80
Rate for Payer: Priority Health SBD	$2.72

ATENOLOL 25 MG TABLET

Facility

$75.20

Service Code	NDC 00093078701
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Cofinity Medicare Advantage	$52.64
Rate for Payer: Encore Health Key Benefits Commercial	$60.16
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$48.88
Rate for Payer: Priority Health SBD	$47.38

ATENOLOL 25 MG TABLET

Facility

$705.00

Service Code	NDC 00093078710
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$282.00
Max. Negotiated Rate	$634.50
Rate for Payer: Aetna Commercial	$599.25
Rate for Payer: Aetna Medicare	$352.50
Rate for Payer: Aetna New Business (MI Preferred)	$458.25
Rate for Payer: BCBS Complete	$282.00
Rate for Payer: Cash Price	$564.00
Rate for Payer: Cofinity Commercial	$493.50
Rate for Payer: Cofinity Commercial	$606.30
Rate for Payer: Cofinity Medicare Advantage	$493.50
Rate for Payer: Encore Health Key Benefits Commercial	$564.00
Rate for Payer: Healthscope Commercial	$634.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.25
Rate for Payer: PHP Commercial	$599.25
Rate for Payer: Priority Health Cigna Priority Health	$458.25
Rate for Payer: Priority Health SBD	$444.15

ATENOLOL 25 MG TABLET

Facility

$430.05

Service Code	NDC 51079075920
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$270.93
Max. Negotiated Rate	$387.04
Rate for Payer: Aetna Commercial	$365.54
Rate for Payer: Aetna New Business (MI Preferred)	$279.53
Rate for Payer: Cash Price	$344.04
Rate for Payer: Cofinity Commercial	$301.04
Rate for Payer: Cofinity Commercial	$369.84
Rate for Payer: Cofinity Medicare Advantage	$301.04
Rate for Payer: Encore Health Key Benefits Commercial	$344.04
Rate for Payer: Healthscope Commercial	$387.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.54
Rate for Payer: PHP Commercial	$365.54
Rate for Payer: Priority Health Cigna Priority Health	$279.53
Rate for Payer: Priority Health SBD	$270.93

ATENOLOL 25 MG TABLET

Facility

$4.31

Service Code	NDC 51079075901
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.88
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare	$2.16
Rate for Payer: Aetna New Business (MI Preferred)	$2.80
Rate for Payer: BCBS Complete	$1.72
Rate for Payer: Cash Price	$3.45
Rate for Payer: Cofinity Commercial	$3.02
Rate for Payer: Cofinity Commercial	$3.71
Rate for Payer: Cofinity Medicare Advantage	$3.02
Rate for Payer: Encore Health Key Benefits Commercial	$3.45
Rate for Payer: Healthscope Commercial	$3.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.66
Rate for Payer: PHP Commercial	$3.66
Rate for Payer: Priority Health Cigna Priority Health	$2.80
Rate for Payer: Priority Health SBD	$2.72

ATENOLOL 25 MG TABLET

Facility

$705.00

Service Code	NDC 00093078710
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$444.15
Max. Negotiated Rate	$634.50
Rate for Payer: Aetna Commercial	$599.25
Rate for Payer: Aetna New Business (MI Preferred)	$458.25
Rate for Payer: Cash Price	$564.00
Rate for Payer: Cofinity Commercial	$493.50
Rate for Payer: Cofinity Commercial	$606.30
Rate for Payer: Cofinity Medicare Advantage	$493.50
Rate for Payer: Encore Health Key Benefits Commercial	$564.00
Rate for Payer: Healthscope Commercial	$634.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$599.25
Rate for Payer: PHP Commercial	$599.25
Rate for Payer: Priority Health Cigna Priority Health	$458.25
Rate for Payer: Priority Health SBD	$444.15

ATENOLOL 25 MG TABLET

Facility

$430.05

Service Code	NDC 51079075920
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$172.02
Max. Negotiated Rate	$387.04
Rate for Payer: Aetna Commercial	$365.54
Rate for Payer: Aetna Medicare	$215.02
Rate for Payer: Aetna New Business (MI Preferred)	$279.53
Rate for Payer: BCBS Complete	$172.02
Rate for Payer: Cash Price	$344.04
Rate for Payer: Cofinity Commercial	$301.04
Rate for Payer: Cofinity Commercial	$369.84
Rate for Payer: Cofinity Medicare Advantage	$301.04
Rate for Payer: Encore Health Key Benefits Commercial	$344.04
Rate for Payer: Healthscope Commercial	$387.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.54
Rate for Payer: PHP Commercial	$365.54
Rate for Payer: Priority Health Cigna Priority Health	$279.53
Rate for Payer: Priority Health SBD	$270.93

ATENOLOL 25 MG TABLET

Facility

$75.20

Service Code	NDC 00093078701
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna Medicare	$37.60
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: BCBS Complete	$30.08
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Cofinity Medicare Advantage	$52.64
Rate for Payer: Encore Health Key Benefits Commercial	$60.16
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$48.88
Rate for Payer: Priority Health SBD	$47.38

ATENOLOL 50 MG TABLET

Facility

$2.12

Service Code	NDC 51079068401
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$1.91
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare	$1.06
Rate for Payer: Aetna New Business (MI Preferred)	$1.38
Rate for Payer: BCBS Complete	$0.85
Rate for Payer: Cash Price	$1.70
Rate for Payer: Cofinity Commercial	$1.48
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Medicare Advantage	$1.48
Rate for Payer: Encore Health Key Benefits Commercial	$1.70
Rate for Payer: Healthscope Commercial	$1.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.80
Rate for Payer: PHP Commercial	$1.80
Rate for Payer: Priority Health Cigna Priority Health	$1.38
Rate for Payer: Priority Health SBD	$1.34

ATENOLOL 50 MG TABLET

Facility

$211.50

Service Code	NDC 51079068420
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$84.60
Max. Negotiated Rate	$190.35
Rate for Payer: Aetna Commercial	$179.78
Rate for Payer: Aetna Medicare	$105.75
Rate for Payer: Aetna New Business (MI Preferred)	$137.48
Rate for Payer: BCBS Complete	$84.60
Rate for Payer: Cash Price	$169.20
Rate for Payer: Cofinity Commercial	$148.05
Rate for Payer: Cofinity Commercial	$181.89
Rate for Payer: Cofinity Medicare Advantage	$148.05
Rate for Payer: Encore Health Key Benefits Commercial	$169.20
Rate for Payer: Healthscope Commercial	$190.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.78
Rate for Payer: PHP Commercial	$179.78
Rate for Payer: Priority Health Cigna Priority Health	$137.48
Rate for Payer: Priority Health SBD	$133.24

ATENOLOL 50 MG TABLET

Facility

$155.10

Service Code	NDC 00378023101
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$62.04
Max. Negotiated Rate	$139.59
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna Medicare	$77.55
Rate for Payer: Aetna New Business (MI Preferred)	$100.82
Rate for Payer: BCBS Complete	$62.04
Rate for Payer: Cash Price	$124.08
Rate for Payer: Cofinity Commercial	$108.57
Rate for Payer: Cofinity Commercial	$133.39
Rate for Payer: Cofinity Medicare Advantage	$108.57
Rate for Payer: Encore Health Key Benefits Commercial	$124.08
Rate for Payer: Healthscope Commercial	$139.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$131.84
Rate for Payer: PHP Commercial	$131.84
Rate for Payer: Priority Health Cigna Priority Health	$100.82
Rate for Payer: Priority Health SBD	$97.71

ATENOLOL 50 MG TABLET

Facility

$2.12

Service Code	NDC 51079068401
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.91
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna New Business (MI Preferred)	$1.38
Rate for Payer: Cash Price	$1.70
Rate for Payer: Cofinity Commercial	$1.48
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Medicare Advantage	$1.48
Rate for Payer: Encore Health Key Benefits Commercial	$1.70
Rate for Payer: Healthscope Commercial	$1.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.80
Rate for Payer: PHP Commercial	$1.80
Rate for Payer: Priority Health Cigna Priority Health	$1.38
Rate for Payer: Priority Health SBD	$1.34

ATENOLOL 50 MG TABLET

Facility

$68.15

Service Code	NDC 65862016901
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$42.93
Max. Negotiated Rate	$61.34
Rate for Payer: Aetna Commercial	$57.93
Rate for Payer: Aetna New Business (MI Preferred)	$44.30
Rate for Payer: Cash Price	$54.52
Rate for Payer: Cofinity Commercial	$47.70
Rate for Payer: Cofinity Commercial	$58.61
Rate for Payer: Cofinity Medicare Advantage	$47.70
Rate for Payer: Encore Health Key Benefits Commercial	$54.52
Rate for Payer: Healthscope Commercial	$61.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.93
Rate for Payer: PHP Commercial	$57.93
Rate for Payer: Priority Health Cigna Priority Health	$44.30
Rate for Payer: Priority Health SBD	$42.93

ATENOLOL 50 MG TABLET

Facility

$211.50

Service Code	NDC 51079068420
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$133.24
Max. Negotiated Rate	$190.35
Rate for Payer: Aetna Commercial	$179.78
Rate for Payer: Aetna New Business (MI Preferred)	$137.48
Rate for Payer: Cash Price	$169.20
Rate for Payer: Cofinity Commercial	$148.05
Rate for Payer: Cofinity Commercial	$181.89
Rate for Payer: Cofinity Medicare Advantage	$148.05
Rate for Payer: Encore Health Key Benefits Commercial	$169.20
Rate for Payer: Healthscope Commercial	$190.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.78
Rate for Payer: PHP Commercial	$179.78
Rate for Payer: Priority Health Cigna Priority Health	$137.48
Rate for Payer: Priority Health SBD	$133.24

ATENOLOL 50 MG TABLET

Facility

$68.15

Service Code	NDC 65862016901
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$61.34
Rate for Payer: Aetna Commercial	$57.93
Rate for Payer: Aetna Medicare	$34.08
Rate for Payer: Aetna New Business (MI Preferred)	$44.30
Rate for Payer: BCBS Complete	$27.26
Rate for Payer: Cash Price	$54.52
Rate for Payer: Cofinity Commercial	$47.70
Rate for Payer: Cofinity Commercial	$58.61
Rate for Payer: Cofinity Medicare Advantage	$47.70
Rate for Payer: Encore Health Key Benefits Commercial	$54.52
Rate for Payer: Healthscope Commercial	$61.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.93
Rate for Payer: PHP Commercial	$57.93
Rate for Payer: Priority Health Cigna Priority Health	$44.30
Rate for Payer: Priority Health SBD	$42.93

Know your out-of-pocket cost for care.

All Charges