Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

PYRAZINAMIDE 500 MG TABLET

Facility

$948.17

Service Code	NDC 61748-012-06
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$597.35
Max. Negotiated Rate	$853.35
Rate for Payer: Aetna Commercial	$805.94
Rate for Payer: Aetna New Business (MI Preferred)	$616.31
Rate for Payer: Cash Price	$758.54
Rate for Payer: Cofinity Commercial	$663.72
Rate for Payer: Cofinity Commercial	$815.43
Rate for Payer: Healthscope Commercial	$853.35
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$805.94
Rate for Payer: PHP Commercial	$805.94
Rate for Payer: Priority Health Cigna Priority Health	$663.72
Rate for Payer: Priority Health SBD	$597.35

PYRAZINAMIDE 500 MG TABLET

Facility

$894.72

Service Code	NDC 61748-012-11
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$563.67
Max. Negotiated Rate	$805.25
Rate for Payer: Aetna Commercial	$760.51
Rate for Payer: Aetna New Business (MI Preferred)	$581.57
Rate for Payer: Cash Price	$715.78
Rate for Payer: Cofinity Commercial	$626.30
Rate for Payer: Cofinity Commercial	$769.46
Rate for Payer: Healthscope Commercial	$805.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$760.51
Rate for Payer: PHP Commercial	$760.51
Rate for Payer: Priority Health Cigna Priority Health	$626.30
Rate for Payer: Priority Health SBD	$563.67

PYRAZINAMIDE 500 MG TABLET

Facility

$1,337.55

Service Code	NDC 70954-484-30
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$842.66
Max. Negotiated Rate	$1,203.80
Rate for Payer: Aetna Commercial	$1,136.92
Rate for Payer: Aetna New Business (MI Preferred)	$869.41
Rate for Payer: Cash Price	$1,070.04
Rate for Payer: Cofinity Commercial	$1,150.29
Rate for Payer: Cofinity Commercial	$936.28
Rate for Payer: Healthscope Commercial	$1,203.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,136.92
Rate for Payer: PHP Commercial	$1,136.92
Rate for Payer: Priority Health Cigna Priority Health	$936.28
Rate for Payer: Priority Health SBD	$842.66

PYRAZINAMIDE 500 MG TABLET

Facility

$1,540.31

Service Code	NDC 61748-012-01
Hospital Charge Code	6738
Hospital Revenue Code	637
Min. Negotiated Rate	$970.40
Max. Negotiated Rate	$1,386.28
Rate for Payer: Aetna Commercial	$1,309.26
Rate for Payer: Aetna New Business (MI Preferred)	$1,001.20
Rate for Payer: Cash Price	$1,232.25
Rate for Payer: Cofinity Commercial	$1,078.22
Rate for Payer: Cofinity Commercial	$1,324.67
Rate for Payer: Healthscope Commercial	$1,386.28
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,309.26
Rate for Payer: PHP Commercial	$1,309.26
Rate for Payer: Priority Health Cigna Priority Health	$1,078.22
Rate for Payer: Priority Health SBD	$970.40

PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION

Facility

$124.60

Service Code	NDC 0781-3040-95
Hospital Charge Code	11237
Hospital Revenue Code	250
Min. Negotiated Rate	$78.50
Max. Negotiated Rate	$112.14
Rate for Payer: Aetna Commercial	$105.91
Rate for Payer: Aetna New Business (MI Preferred)	$80.99
Rate for Payer: Cash Price	$99.68
Rate for Payer: Cofinity Commercial	$107.16
Rate for Payer: Cofinity Commercial	$87.22
Rate for Payer: Healthscope Commercial	$112.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$105.91
Rate for Payer: PHP Commercial	$105.91
Rate for Payer: Priority Health Cigna Priority Health	$87.22
Rate for Payer: Priority Health SBD	$78.50

PYRIDOSTIGMINE BROMIDE 5 MG/ML INJECTION SOLUTION

Facility

$124.60

Service Code	NDC 0781-3040-72
Hospital Charge Code	11237
Hospital Revenue Code	250
Min. Negotiated Rate	$78.50
Max. Negotiated Rate	$112.14
Rate for Payer: Aetna Commercial	$105.91
Rate for Payer: Aetna New Business (MI Preferred)	$80.99
Rate for Payer: Cash Price	$99.68
Rate for Payer: Cofinity Commercial	$107.16
Rate for Payer: Cofinity Commercial	$87.22
Rate for Payer: Healthscope Commercial	$112.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$105.91
Rate for Payer: PHP Commercial	$105.91
Rate for Payer: Priority Health Cigna Priority Health	$87.22
Rate for Payer: Priority Health SBD	$78.50

PYRIDOSTIGMINE BROMIDE 60 MG TABLET

Facility

$364.32

Service Code	NDC 0115-3511-01
Hospital Charge Code	11239
Hospital Revenue Code	637
Min. Negotiated Rate	$229.52
Max. Negotiated Rate	$327.89
Rate for Payer: Aetna Commercial	$309.67
Rate for Payer: Aetna New Business (MI Preferred)	$236.81
Rate for Payer: Cash Price	$291.46
Rate for Payer: Cofinity Commercial	$255.02
Rate for Payer: Cofinity Commercial	$313.32
Rate for Payer: Healthscope Commercial	$327.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$309.67
Rate for Payer: PHP Commercial	$309.67
Rate for Payer: Priority Health Cigna Priority Health	$255.02
Rate for Payer: Priority Health SBD	$229.52

PYRIDOSTIGMINE BROMIDE 60 MG TABLET

Facility

$5.59

Service Code	NDC 68084-494-11
Hospital Charge Code	11239
Hospital Revenue Code	637
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$5.03
Rate for Payer: Aetna Commercial	$4.75
Rate for Payer: Aetna New Business (MI Preferred)	$3.63
Rate for Payer: Cash Price	$4.47
Rate for Payer: Cofinity Commercial	$3.91
Rate for Payer: Cofinity Commercial	$4.81
Rate for Payer: Healthscope Commercial	$5.03
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4.75
Rate for Payer: PHP Commercial	$4.75
Rate for Payer: Priority Health Cigna Priority Health	$3.91
Rate for Payer: Priority Health SBD	$3.52

PYRIDOSTIGMINE BROMIDE 60 MG TABLET

Facility

$558.72

Service Code	NDC 68084-494-01
Hospital Charge Code	11239
Hospital Revenue Code	637
Min. Negotiated Rate	$351.99
Max. Negotiated Rate	$502.85
Rate for Payer: Aetna Commercial	$474.91
Rate for Payer: Aetna New Business (MI Preferred)	$363.17
Rate for Payer: Cash Price	$446.98
Rate for Payer: Cofinity Commercial	$391.10
Rate for Payer: Cofinity Commercial	$480.50
Rate for Payer: Healthscope Commercial	$502.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$474.91
Rate for Payer: PHP Commercial	$474.91
Rate for Payer: Priority Health Cigna Priority Health	$391.10
Rate for Payer: Priority Health SBD	$351.99

PYRIDOSTIGMINE BROMIDE 60 MG TABLET

Facility

$433.20

Service Code	NDC 68682-302-10
Hospital Charge Code	11239
Hospital Revenue Code	637
Min. Negotiated Rate	$272.92
Max. Negotiated Rate	$389.88
Rate for Payer: Aetna Commercial	$368.22
Rate for Payer: Aetna New Business (MI Preferred)	$281.58
Rate for Payer: Cash Price	$346.56
Rate for Payer: Cofinity Commercial	$303.24
Rate for Payer: Cofinity Commercial	$372.55
Rate for Payer: Healthscope Commercial	$389.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$368.22
Rate for Payer: PHP Commercial	$368.22
Rate for Payer: Priority Health Cigna Priority Health	$303.24
Rate for Payer: Priority Health SBD	$272.92

PYRIDOSTIGMINE BROMIDE 60 MG TABLET

Facility

$421.92

Service Code	NDC 0904-6622-61
Hospital Charge Code	11239
Hospital Revenue Code	637
Min. Negotiated Rate	$265.81
Max. Negotiated Rate	$379.73
Rate for Payer: Aetna Commercial	$358.63
Rate for Payer: Aetna New Business (MI Preferred)	$274.25
Rate for Payer: Cash Price	$337.54
Rate for Payer: Cofinity Commercial	$295.34
Rate for Payer: Cofinity Commercial	$362.85
Rate for Payer: Healthscope Commercial	$379.73
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$358.63
Rate for Payer: PHP Commercial	$358.63
Rate for Payer: Priority Health Cigna Priority Health	$295.34
Rate for Payer: Priority Health SBD	$265.81

PYRIDOXINE (VITAMIN B6) 100 MG/ML INJECTION SOLUTION

Facility

$78.84

Service Code	HCPCS J3415
Hospital Charge Code	6744
Hospital Revenue Code	636
Min. Negotiated Rate	$49.67
Max. Negotiated Rate	$70.96
Rate for Payer: Aetna Commercial	$67.01
Rate for Payer: Aetna New Business (MI Preferred)	$51.25
Rate for Payer: Cash Price	$63.07
Rate for Payer: Cofinity Commercial	$55.19
Rate for Payer: Cofinity Commercial	$67.80
Rate for Payer: Healthscope Commercial	$70.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$67.01
Rate for Payer: PHP Commercial	$67.01
Rate for Payer: Priority Health Cigna Priority Health	$55.19
Rate for Payer: Priority Health SBD	$49.67

PYRIDOXINE (VITAMIN B6) 50 MG TABLET

Facility

$124.30

Service Code	NDC 7733394010
Hospital Charge Code	6748
Hospital Revenue Code	637
Min. Negotiated Rate	$78.31
Max. Negotiated Rate	$111.87
Rate for Payer: Aetna Commercial	$105.66
Rate for Payer: Aetna New Business (MI Preferred)	$80.80
Rate for Payer: Cash Price	$99.44
Rate for Payer: Cofinity Commercial	$106.90
Rate for Payer: Cofinity Commercial	$87.01
Rate for Payer: Healthscope Commercial	$111.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$105.66
Rate for Payer: PHP Commercial	$105.66
Rate for Payer: Priority Health Cigna Priority Health	$87.01
Rate for Payer: Priority Health SBD	$78.31

PYRIDOXINE (VITAMIN B6) 50 MG TABLET

Facility

$1.25

Service Code	NDC 7733394025
Hospital Charge Code	6748
Hospital Revenue Code	637
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$1.12
Rate for Payer: Aetna Commercial	$1.06
Rate for Payer: Aetna New Business (MI Preferred)	$0.81
Rate for Payer: Cash Price	$1.00
Rate for Payer: Cofinity Commercial	$0.88
Rate for Payer: Cofinity Commercial	$1.08
Rate for Payer: Healthscope Commercial	$1.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.06
Rate for Payer: PHP Commercial	$1.06
Rate for Payer: Priority Health Cigna Priority Health	$0.88
Rate for Payer: Priority Health SBD	$0.79

QUETIAPINE 100 MG TABLET

Facility

$314.90

Service Code	NDC 0904-6640-61
Hospital Charge Code	21824
Hospital Revenue Code	637
Min. Negotiated Rate	$198.39
Max. Negotiated Rate	$283.41
Rate for Payer: Aetna Commercial	$267.66
Rate for Payer: Aetna New Business (MI Preferred)	$204.68
Rate for Payer: Cash Price	$251.92
Rate for Payer: Cofinity Commercial	$220.43
Rate for Payer: Cofinity Commercial	$270.81
Rate for Payer: Healthscope Commercial	$283.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$267.66
Rate for Payer: PHP Commercial	$267.66
Rate for Payer: Priority Health Cigna Priority Health	$220.43
Rate for Payer: Priority Health SBD	$198.39

QUETIAPINE 100 MG TABLET

Facility

$281.20

Service Code	NDC 47335-904-88
Hospital Charge Code	21824
Hospital Revenue Code	637
Min. Negotiated Rate	$177.16
Max. Negotiated Rate	$253.08
Rate for Payer: Aetna Commercial	$239.02
Rate for Payer: Aetna New Business (MI Preferred)	$182.78
Rate for Payer: Cash Price	$224.96
Rate for Payer: Cofinity Commercial	$196.84
Rate for Payer: Cofinity Commercial	$241.83
Rate for Payer: Healthscope Commercial	$253.08
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$239.02
Rate for Payer: PHP Commercial	$239.02
Rate for Payer: Priority Health Cigna Priority Health	$196.84
Rate for Payer: Priority Health SBD	$177.16

QUETIAPINE 200 MG TABLET

Facility

$255.55

Service Code	NDC 0904-6641-61
Hospital Charge Code	21825
Hospital Revenue Code	637
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$230.00
Rate for Payer: Aetna Commercial	$217.22
Rate for Payer: Aetna New Business (MI Preferred)	$166.11
Rate for Payer: Cash Price	$204.44
Rate for Payer: Cofinity Commercial	$178.88
Rate for Payer: Cofinity Commercial	$219.77
Rate for Payer: Healthscope Commercial	$230.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$217.22
Rate for Payer: PHP Commercial	$217.22
Rate for Payer: Priority Health Cigna Priority Health	$178.88
Rate for Payer: Priority Health SBD	$161.00

QUETIAPINE 200 MG TABLET

Facility

$424.32

Service Code	NDC 63739-677-10
Hospital Charge Code	21825
Hospital Revenue Code	637
Min. Negotiated Rate	$267.32
Max. Negotiated Rate	$381.89
Rate for Payer: Aetna Commercial	$360.67
Rate for Payer: Aetna New Business (MI Preferred)	$275.81
Rate for Payer: Cash Price	$339.46
Rate for Payer: Cofinity Commercial	$297.02
Rate for Payer: Cofinity Commercial	$364.92
Rate for Payer: Healthscope Commercial	$381.89
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$360.67
Rate for Payer: PHP Commercial	$360.67
Rate for Payer: Priority Health Cigna Priority Health	$297.02
Rate for Payer: Priority Health SBD	$267.32

QUETIAPINE 200 MG TABLET

Facility

$4,327.89

Service Code	NDC 0310-0272-10
Hospital Charge Code	21825
Hospital Revenue Code	637
Min. Negotiated Rate	$2,726.57
Max. Negotiated Rate	$3,895.10
Rate for Payer: Aetna Commercial	$3,678.71
Rate for Payer: Aetna New Business (MI Preferred)	$2,813.13
Rate for Payer: Cash Price	$3,462.31
Rate for Payer: Cofinity Commercial	$3,029.52
Rate for Payer: Cofinity Commercial	$3,721.99
Rate for Payer: Healthscope Commercial	$3,895.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,678.71
Rate for Payer: PHP Commercial	$3,678.71
Rate for Payer: Priority Health Cigna Priority Health	$3,029.52
Rate for Payer: Priority Health SBD	$2,726.57

QUETIAPINE 25 MG TABLET

Facility

$54.05

Service Code	NDC 67877-242-01
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$48.64
Rate for Payer: Aetna Commercial	$45.94
Rate for Payer: Aetna New Business (MI Preferred)	$35.13
Rate for Payer: Cash Price	$43.24
Rate for Payer: Cofinity Commercial	$37.84
Rate for Payer: Cofinity Commercial	$46.48
Rate for Payer: Healthscope Commercial	$48.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$45.94
Rate for Payer: PHP Commercial	$45.94
Rate for Payer: Priority Health Cigna Priority Health	$37.84
Rate for Payer: Priority Health SBD	$34.05

QUETIAPINE 25 MG TABLET

Facility

$3.62

Service Code	NDC 60687-327-11
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$3.26
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.35
Rate for Payer: Cash Price	$2.90
Rate for Payer: Cofinity Commercial	$2.53
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Healthscope Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.08
Rate for Payer: PHP Commercial	$3.08
Rate for Payer: Priority Health Cigna Priority Health	$2.53
Rate for Payer: Priority Health SBD	$2.28

QUETIAPINE 25 MG TABLET

Facility

$176.25

Service Code	NDC 50268-630-15
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$111.04
Max. Negotiated Rate	$158.62
Rate for Payer: Aetna Commercial	$149.81
Rate for Payer: Aetna New Business (MI Preferred)	$114.56
Rate for Payer: Cash Price	$141.00
Rate for Payer: Cofinity Commercial	$123.38
Rate for Payer: Cofinity Commercial	$151.58
Rate for Payer: Healthscope Commercial	$158.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$149.81
Rate for Payer: PHP Commercial	$149.81
Rate for Payer: Priority Health Cigna Priority Health	$123.38
Rate for Payer: Priority Health SBD	$111.04

QUETIAPINE 25 MG TABLET

Facility

$3.53

Service Code	NDC 50268-630-11
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$3.18
Rate for Payer: Aetna Commercial	$3.00
Rate for Payer: Aetna New Business (MI Preferred)	$2.29
Rate for Payer: Cash Price	$2.82
Rate for Payer: Cofinity Commercial	$2.47
Rate for Payer: Cofinity Commercial	$3.04
Rate for Payer: Healthscope Commercial	$3.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.00
Rate for Payer: PHP Commercial	$3.00
Rate for Payer: Priority Health Cigna Priority Health	$2.47
Rate for Payer: Priority Health SBD	$2.22

QUETIAPINE 25 MG TABLET

Facility

$361.90

Service Code	NDC 60687-327-01
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$325.71
Rate for Payer: Aetna Commercial	$307.62
Rate for Payer: Aetna New Business (MI Preferred)	$235.24
Rate for Payer: Cash Price	$289.52
Rate for Payer: Cofinity Commercial	$253.33
Rate for Payer: Cofinity Commercial	$311.23
Rate for Payer: Healthscope Commercial	$325.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$307.62
Rate for Payer: PHP Commercial	$307.62
Rate for Payer: Priority Health Cigna Priority Health	$253.33
Rate for Payer: Priority Health SBD	$228.00

QUETIAPINE 25 MG TABLET

Facility

$244.40

Service Code	NDC 0904-6638-61
Hospital Charge Code	21823
Hospital Revenue Code	637
Min. Negotiated Rate	$153.97
Max. Negotiated Rate	$219.96
Rate for Payer: Aetna Commercial	$207.74
Rate for Payer: Aetna New Business (MI Preferred)	$158.86
Rate for Payer: Cash Price	$195.52
Rate for Payer: Cofinity Commercial	$171.08
Rate for Payer: Cofinity Commercial	$210.18
Rate for Payer: Healthscope Commercial	$219.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$207.74
Rate for Payer: PHP Commercial	$207.74
Rate for Payer: Priority Health Cigna Priority Health	$171.08
Rate for Payer: Priority Health SBD	$153.97

Know your out-of-pocket cost for care.

All Charges