Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PILOCARPINE 1 % EYE DROPS

Facility

$304.61

Service Code	NDC 00998020315
Hospital Charge Code	6279
Hospital Revenue Code	637
Min. Negotiated Rate	$121.84
Max. Negotiated Rate	$274.15
Rate for Payer: Aetna Commercial	$258.92
Rate for Payer: Aetna Medicare	$152.31
Rate for Payer: Aetna New Business (MI Preferred)	$198.00
Rate for Payer: BCBS Complete	$121.84
Rate for Payer: Cash Price	$243.69
Rate for Payer: Cofinity Commercial	$213.23
Rate for Payer: Cofinity Commercial	$261.96
Rate for Payer: Cofinity Medicare Advantage	$213.23
Rate for Payer: Encore Health Key Benefits Commercial	$243.69
Rate for Payer: Healthscope Commercial	$274.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$258.92
Rate for Payer: PHP Commercial	$258.92
Rate for Payer: Priority Health Cigna Priority Health	$198.00
Rate for Payer: Priority Health SBD	$191.90

PILOCARPINE 2 % EYE DROPS

Facility

$209.95

Service Code	NDC 69238174608
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$132.27
Max. Negotiated Rate	$188.96
Rate for Payer: Aetna Commercial	$178.46
Rate for Payer: Aetna New Business (MI Preferred)	$136.47
Rate for Payer: Cash Price	$167.96
Rate for Payer: Cofinity Commercial	$146.97
Rate for Payer: Cofinity Commercial	$180.56
Rate for Payer: Cofinity Medicare Advantage	$146.97
Rate for Payer: Encore Health Key Benefits Commercial	$167.96
Rate for Payer: Healthscope Commercial	$188.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$178.46
Rate for Payer: PHP Commercial	$178.46
Rate for Payer: Priority Health Cigna Priority Health	$136.47
Rate for Payer: Priority Health SBD	$132.27

PILOCARPINE 2 % EYE DROPS

Facility

$311.54

Service Code	NDC 00998020415
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$124.62
Max. Negotiated Rate	$280.39
Rate for Payer: Aetna Commercial	$264.81
Rate for Payer: Aetna Medicare	$155.77
Rate for Payer: Aetna New Business (MI Preferred)	$202.50
Rate for Payer: BCBS Complete	$124.62
Rate for Payer: Cash Price	$249.23
Rate for Payer: Cofinity Commercial	$218.08
Rate for Payer: Cofinity Commercial	$267.92
Rate for Payer: Cofinity Medicare Advantage	$218.08
Rate for Payer: Encore Health Key Benefits Commercial	$249.23
Rate for Payer: Healthscope Commercial	$280.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$264.81
Rate for Payer: PHP Commercial	$264.81
Rate for Payer: Priority Health Cigna Priority Health	$202.50
Rate for Payer: Priority Health SBD	$196.27

PILOCARPINE 2 % EYE DROPS

Facility

$136.19

Service Code	NDC 61314020415
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$122.57
Rate for Payer: Aetna Commercial	$115.76
Rate for Payer: Aetna New Business (MI Preferred)	$88.52
Rate for Payer: Cash Price	$108.95
Rate for Payer: Cofinity Commercial	$117.12
Rate for Payer: Cofinity Commercial	$95.33
Rate for Payer: Cofinity Medicare Advantage	$95.33
Rate for Payer: Encore Health Key Benefits Commercial	$108.95
Rate for Payer: Healthscope Commercial	$122.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.76
Rate for Payer: PHP Commercial	$115.76
Rate for Payer: Priority Health Cigna Priority Health	$88.52
Rate for Payer: Priority Health SBD	$85.80

PILOCARPINE 2 % EYE DROPS

Facility

$136.19

Service Code	NDC 61314020415
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$54.48
Max. Negotiated Rate	$122.57
Rate for Payer: Aetna Commercial	$115.76
Rate for Payer: Aetna Medicare	$68.09
Rate for Payer: Aetna New Business (MI Preferred)	$88.52
Rate for Payer: BCBS Complete	$54.48
Rate for Payer: Cash Price	$108.95
Rate for Payer: Cofinity Commercial	$117.12
Rate for Payer: Cofinity Commercial	$95.33
Rate for Payer: Cofinity Medicare Advantage	$95.33
Rate for Payer: Encore Health Key Benefits Commercial	$108.95
Rate for Payer: Healthscope Commercial	$122.57
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$115.76
Rate for Payer: PHP Commercial	$115.76
Rate for Payer: Priority Health Cigna Priority Health	$88.52
Rate for Payer: Priority Health SBD	$85.80

PILOCARPINE 2 % EYE DROPS

Facility

$209.95

Service Code	NDC 69238174608
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$83.98
Max. Negotiated Rate	$188.96
Rate for Payer: Aetna Commercial	$178.46
Rate for Payer: Aetna Medicare	$104.97
Rate for Payer: Aetna New Business (MI Preferred)	$136.47
Rate for Payer: BCBS Complete	$83.98
Rate for Payer: Cash Price	$167.96
Rate for Payer: Cofinity Commercial	$146.97
Rate for Payer: Cofinity Commercial	$180.56
Rate for Payer: Cofinity Medicare Advantage	$146.97
Rate for Payer: Encore Health Key Benefits Commercial	$167.96
Rate for Payer: Healthscope Commercial	$188.96
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$178.46
Rate for Payer: PHP Commercial	$178.46
Rate for Payer: Priority Health Cigna Priority Health	$136.47
Rate for Payer: Priority Health SBD	$132.27

PILOCARPINE 2 % EYE DROPS

Facility

$311.54

Service Code	NDC 00998020415
Hospital Charge Code	6280
Hospital Revenue Code	637
Min. Negotiated Rate	$196.27
Max. Negotiated Rate	$280.39
Rate for Payer: Aetna Commercial	$264.81
Rate for Payer: Aetna New Business (MI Preferred)	$202.50
Rate for Payer: Cash Price	$249.23
Rate for Payer: Cofinity Commercial	$218.08
Rate for Payer: Cofinity Commercial	$267.92
Rate for Payer: Cofinity Medicare Advantage	$218.08
Rate for Payer: Encore Health Key Benefits Commercial	$249.23
Rate for Payer: Healthscope Commercial	$280.39
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$264.81
Rate for Payer: PHP Commercial	$264.81
Rate for Payer: Priority Health Cigna Priority Health	$202.50
Rate for Payer: Priority Health SBD	$196.27

PIMAVANSERIN 34 MG CAPSULE

Facility

$18,481.50

Service Code	NDC 63090034030
Hospital Charge Code	187560
Hospital Revenue Code	637
Min. Negotiated Rate	$11,643.34
Max. Negotiated Rate	$16,633.35
Rate for Payer: Aetna Commercial	$15,709.27
Rate for Payer: Aetna New Business (MI Preferred)	$12,012.98
Rate for Payer: Cash Price	$14,785.20
Rate for Payer: Cofinity Commercial	$12,937.05
Rate for Payer: Cofinity Commercial	$15,894.09
Rate for Payer: Cofinity Medicare Advantage	$12,937.05
Rate for Payer: Encore Health Key Benefits Commercial	$14,785.20
Rate for Payer: Healthscope Commercial	$16,633.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,709.27
Rate for Payer: PHP Commercial	$15,709.27
Rate for Payer: Priority Health Cigna Priority Health	$12,012.98
Rate for Payer: Priority Health SBD	$11,643.34

PIMAVANSERIN 34 MG CAPSULE

Facility

$18,481.50

Service Code	NDC 63090034030
Hospital Charge Code	187560
Hospital Revenue Code	637
Min. Negotiated Rate	$7,392.60
Max. Negotiated Rate	$16,633.35
Rate for Payer: Aetna Commercial	$15,709.27
Rate for Payer: Aetna Medicare	$9,240.75
Rate for Payer: Aetna New Business (MI Preferred)	$12,012.98
Rate for Payer: BCBS Complete	$7,392.60
Rate for Payer: Cash Price	$14,785.20
Rate for Payer: Cofinity Commercial	$12,937.05
Rate for Payer: Cofinity Commercial	$15,894.09
Rate for Payer: Cofinity Medicare Advantage	$12,937.05
Rate for Payer: Encore Health Key Benefits Commercial	$14,785.20
Rate for Payer: Healthscope Commercial	$16,633.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15,709.27
Rate for Payer: PHP Commercial	$15,709.27
Rate for Payer: Priority Health Cigna Priority Health	$12,012.98
Rate for Payer: Priority Health SBD	$11,643.34

PIOGLITAZONE 15 MG TABLET

Facility

$1,337.11

Service Code	NDC 64764015104
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$842.38
Max. Negotiated Rate	$1,203.40
Rate for Payer: Aetna Commercial	$1,136.54
Rate for Payer: Aetna New Business (MI Preferred)	$869.12
Rate for Payer: Cash Price	$1,069.69
Rate for Payer: Cofinity Commercial	$1,149.91
Rate for Payer: Cofinity Commercial	$935.98
Rate for Payer: Cofinity Medicare Advantage	$935.98
Rate for Payer: Encore Health Key Benefits Commercial	$1,069.69
Rate for Payer: Healthscope Commercial	$1,203.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,136.54
Rate for Payer: PHP Commercial	$1,136.54
Rate for Payer: Priority Health Cigna Priority Health	$869.12
Rate for Payer: Priority Health SBD	$842.38

PIOGLITAZONE 15 MG TABLET

Facility

$5.43

Service Code	NDC 51079051301
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$4.89
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna Medicare	$2.71
Rate for Payer: Aetna New Business (MI Preferred)	$3.53
Rate for Payer: BCBS Complete	$2.17
Rate for Payer: Cash Price	$4.34
Rate for Payer: Cofinity Commercial	$3.80
Rate for Payer: Cofinity Commercial	$4.67
Rate for Payer: Cofinity Medicare Advantage	$3.80
Rate for Payer: Encore Health Key Benefits Commercial	$4.34
Rate for Payer: Healthscope Commercial	$4.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.62
Rate for Payer: PHP Commercial	$4.62
Rate for Payer: Priority Health Cigna Priority Health	$3.53
Rate for Payer: Priority Health SBD	$3.42

PIOGLITAZONE 15 MG TABLET

Facility

$490.56

Service Code	NDC 60687039101
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$196.22
Max. Negotiated Rate	$441.50
Rate for Payer: Aetna Commercial	$416.98
Rate for Payer: Aetna Medicare	$245.28
Rate for Payer: Aetna New Business (MI Preferred)	$318.86
Rate for Payer: BCBS Complete	$196.22
Rate for Payer: Cash Price	$392.45
Rate for Payer: Cofinity Commercial	$343.39
Rate for Payer: Cofinity Commercial	$421.88
Rate for Payer: Cofinity Medicare Advantage	$343.39
Rate for Payer: Encore Health Key Benefits Commercial	$392.45
Rate for Payer: Healthscope Commercial	$441.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$416.98
Rate for Payer: PHP Commercial	$416.98
Rate for Payer: Priority Health Cigna Priority Health	$318.86
Rate for Payer: Priority Health SBD	$309.05

PIOGLITAZONE 15 MG TABLET

Facility

$74.39

Service Code	NDC 00093727156
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$29.76
Max. Negotiated Rate	$66.95
Rate for Payer: Aetna Commercial	$63.23
Rate for Payer: Aetna Medicare	$37.20
Rate for Payer: Aetna New Business (MI Preferred)	$48.35
Rate for Payer: BCBS Complete	$29.76
Rate for Payer: Cash Price	$59.51
Rate for Payer: Cofinity Commercial	$52.07
Rate for Payer: Cofinity Commercial	$63.98
Rate for Payer: Cofinity Medicare Advantage	$52.07
Rate for Payer: Encore Health Key Benefits Commercial	$59.51
Rate for Payer: Healthscope Commercial	$66.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.23
Rate for Payer: PHP Commercial	$63.23
Rate for Payer: Priority Health Cigna Priority Health	$48.35
Rate for Payer: Priority Health SBD	$46.87

PIOGLITAZONE 15 MG TABLET

Facility

$542.88

Service Code	NDC 51079051320
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$217.15
Max. Negotiated Rate	$488.59
Rate for Payer: Aetna Commercial	$461.45
Rate for Payer: Aetna Medicare	$271.44
Rate for Payer: Aetna New Business (MI Preferred)	$352.87
Rate for Payer: BCBS Complete	$217.15
Rate for Payer: Cash Price	$434.30
Rate for Payer: Cofinity Commercial	$380.02
Rate for Payer: Cofinity Commercial	$466.88
Rate for Payer: Cofinity Medicare Advantage	$380.02
Rate for Payer: Encore Health Key Benefits Commercial	$434.30
Rate for Payer: Healthscope Commercial	$488.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$461.45
Rate for Payer: PHP Commercial	$461.45
Rate for Payer: Priority Health Cigna Priority Health	$352.87
Rate for Payer: Priority Health SBD	$342.01

PIOGLITAZONE 15 MG TABLET

Facility

$264.38

Service Code	NDC 16729002015
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$105.75
Max. Negotiated Rate	$237.94
Rate for Payer: Aetna Commercial	$224.72
Rate for Payer: Aetna Medicare	$132.19
Rate for Payer: Aetna New Business (MI Preferred)	$171.85
Rate for Payer: BCBS Complete	$105.75
Rate for Payer: Cash Price	$211.50
Rate for Payer: Cofinity Commercial	$185.07
Rate for Payer: Cofinity Commercial	$227.37
Rate for Payer: Cofinity Medicare Advantage	$185.07
Rate for Payer: Encore Health Key Benefits Commercial	$211.50
Rate for Payer: Healthscope Commercial	$237.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.72
Rate for Payer: PHP Commercial	$224.72
Rate for Payer: Priority Health Cigna Priority Health	$171.85
Rate for Payer: Priority Health SBD	$166.56

PIOGLITAZONE 15 MG TABLET

Facility

$4.91

Service Code	NDC 60687039111
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$3.09
Max. Negotiated Rate	$4.42
Rate for Payer: Aetna Commercial	$4.17
Rate for Payer: Aetna New Business (MI Preferred)	$3.19
Rate for Payer: Cash Price	$3.93
Rate for Payer: Cofinity Commercial	$3.44
Rate for Payer: Cofinity Commercial	$4.22
Rate for Payer: Cofinity Medicare Advantage	$3.44
Rate for Payer: Encore Health Key Benefits Commercial	$3.93
Rate for Payer: Healthscope Commercial	$4.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.17
Rate for Payer: PHP Commercial	$4.17
Rate for Payer: Priority Health Cigna Priority Health	$3.19
Rate for Payer: Priority Health SBD	$3.09

PIOGLITAZONE 15 MG TABLET

Facility

$58.52

Service Code	NDC 16729002010
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$23.41
Max. Negotiated Rate	$52.67
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: Aetna Medicare	$29.26
Rate for Payer: Aetna New Business (MI Preferred)	$38.04
Rate for Payer: BCBS Complete	$23.41
Rate for Payer: Cash Price	$46.82
Rate for Payer: Cofinity Commercial	$40.96
Rate for Payer: Cofinity Commercial	$50.33
Rate for Payer: Cofinity Medicare Advantage	$40.96
Rate for Payer: Encore Health Key Benefits Commercial	$46.82
Rate for Payer: Healthscope Commercial	$52.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.74
Rate for Payer: PHP Commercial	$49.74
Rate for Payer: Priority Health Cigna Priority Health	$38.04
Rate for Payer: Priority Health SBD	$36.87

PIOGLITAZONE 15 MG TABLET

Facility

$4.91

Service Code	NDC 60687039111
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$4.42
Rate for Payer: Aetna Commercial	$4.17
Rate for Payer: Aetna Medicare	$2.46
Rate for Payer: Aetna New Business (MI Preferred)	$3.19
Rate for Payer: BCBS Complete	$1.96
Rate for Payer: Cash Price	$3.93
Rate for Payer: Cofinity Commercial	$3.44
Rate for Payer: Cofinity Commercial	$4.22
Rate for Payer: Cofinity Medicare Advantage	$3.44
Rate for Payer: Encore Health Key Benefits Commercial	$3.93
Rate for Payer: Healthscope Commercial	$4.42
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.17
Rate for Payer: PHP Commercial	$4.17
Rate for Payer: Priority Health Cigna Priority Health	$3.19
Rate for Payer: Priority Health SBD	$3.09

PIOGLITAZONE 15 MG TABLET

Facility

$264.38

Service Code	NDC 16729002015
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$237.94
Rate for Payer: Aetna Commercial	$224.72
Rate for Payer: Aetna New Business (MI Preferred)	$171.85
Rate for Payer: Cash Price	$211.50
Rate for Payer: Cofinity Commercial	$185.07
Rate for Payer: Cofinity Commercial	$227.37
Rate for Payer: Cofinity Medicare Advantage	$185.07
Rate for Payer: Encore Health Key Benefits Commercial	$211.50
Rate for Payer: Healthscope Commercial	$237.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$224.72
Rate for Payer: PHP Commercial	$224.72
Rate for Payer: Priority Health Cigna Priority Health	$171.85
Rate for Payer: Priority Health SBD	$166.56

PIOGLITAZONE 15 MG TABLET

Facility

$58.52

Service Code	NDC 16729002010
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$52.67
Rate for Payer: Aetna Commercial	$49.74
Rate for Payer: Aetna New Business (MI Preferred)	$38.04
Rate for Payer: Cash Price	$46.82
Rate for Payer: Cofinity Commercial	$40.96
Rate for Payer: Cofinity Commercial	$50.33
Rate for Payer: Cofinity Medicare Advantage	$40.96
Rate for Payer: Encore Health Key Benefits Commercial	$46.82
Rate for Payer: Healthscope Commercial	$52.67
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$49.74
Rate for Payer: PHP Commercial	$49.74
Rate for Payer: Priority Health Cigna Priority Health	$38.04
Rate for Payer: Priority Health SBD	$36.87

PIOGLITAZONE 15 MG TABLET

Facility

$5.43

Service Code	NDC 51079051301
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$4.89
Rate for Payer: Aetna Commercial	$4.62
Rate for Payer: Aetna New Business (MI Preferred)	$3.53
Rate for Payer: Cash Price	$4.34
Rate for Payer: Cofinity Commercial	$3.80
Rate for Payer: Cofinity Commercial	$4.67
Rate for Payer: Cofinity Medicare Advantage	$3.80
Rate for Payer: Encore Health Key Benefits Commercial	$4.34
Rate for Payer: Healthscope Commercial	$4.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.62
Rate for Payer: PHP Commercial	$4.62
Rate for Payer: Priority Health Cigna Priority Health	$3.53
Rate for Payer: Priority Health SBD	$3.42

PIOGLITAZONE 15 MG TABLET

Facility

$490.56

Service Code	NDC 60687039101
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$309.05
Max. Negotiated Rate	$441.50
Rate for Payer: Aetna Commercial	$416.98
Rate for Payer: Aetna New Business (MI Preferred)	$318.86
Rate for Payer: Cash Price	$392.45
Rate for Payer: Cofinity Commercial	$343.39
Rate for Payer: Cofinity Commercial	$421.88
Rate for Payer: Cofinity Medicare Advantage	$343.39
Rate for Payer: Encore Health Key Benefits Commercial	$392.45
Rate for Payer: Healthscope Commercial	$441.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$416.98
Rate for Payer: PHP Commercial	$416.98
Rate for Payer: Priority Health Cigna Priority Health	$318.86
Rate for Payer: Priority Health SBD	$309.05

PIOGLITAZONE 15 MG TABLET

Facility

$74.39

Service Code	NDC 00093727156
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$46.87
Max. Negotiated Rate	$66.95
Rate for Payer: Aetna Commercial	$63.23
Rate for Payer: Aetna New Business (MI Preferred)	$48.35
Rate for Payer: Cash Price	$59.51
Rate for Payer: Cofinity Commercial	$52.07
Rate for Payer: Cofinity Commercial	$63.98
Rate for Payer: Cofinity Medicare Advantage	$52.07
Rate for Payer: Encore Health Key Benefits Commercial	$59.51
Rate for Payer: Healthscope Commercial	$66.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.23
Rate for Payer: PHP Commercial	$63.23
Rate for Payer: Priority Health Cigna Priority Health	$48.35
Rate for Payer: Priority Health SBD	$46.87

PIOGLITAZONE 15 MG TABLET

Facility

$542.88

Service Code	NDC 51079051320
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$342.01
Max. Negotiated Rate	$488.59
Rate for Payer: Aetna Commercial	$461.45
Rate for Payer: Aetna New Business (MI Preferred)	$352.87
Rate for Payer: Cash Price	$434.30
Rate for Payer: Cofinity Commercial	$380.02
Rate for Payer: Cofinity Commercial	$466.88
Rate for Payer: Cofinity Medicare Advantage	$380.02
Rate for Payer: Encore Health Key Benefits Commercial	$434.30
Rate for Payer: Healthscope Commercial	$488.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$461.45
Rate for Payer: PHP Commercial	$461.45
Rate for Payer: Priority Health Cigna Priority Health	$352.87
Rate for Payer: Priority Health SBD	$342.01

PIOGLITAZONE 15 MG TABLET

Facility

$1,337.11

Service Code	NDC 64764015104
Hospital Charge Code	25528
Hospital Revenue Code	637
Min. Negotiated Rate	$534.84
Max. Negotiated Rate	$1,203.40
Rate for Payer: Aetna Commercial	$1,136.54
Rate for Payer: Aetna Medicare	$668.55
Rate for Payer: Aetna New Business (MI Preferred)	$869.12
Rate for Payer: BCBS Complete	$534.84
Rate for Payer: Cash Price	$1,069.69
Rate for Payer: Cofinity Commercial	$1,149.91
Rate for Payer: Cofinity Commercial	$935.98
Rate for Payer: Cofinity Medicare Advantage	$935.98
Rate for Payer: Encore Health Key Benefits Commercial	$1,069.69
Rate for Payer: Healthscope Commercial	$1,203.40
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1,136.54
Rate for Payer: PHP Commercial	$1,136.54
Rate for Payer: Priority Health Cigna Priority Health	$869.12
Rate for Payer: Priority Health SBD	$842.38

Know your out-of-pocket cost for care.

All Charges