Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

RIVAROXABAN 20 MG TABLET

Facility

$6.35

Service Code	NDC 50458-579-30
Hospital Charge Code	155831
Hospital Revenue Code	637
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$5.72
Rate for Payer: Aetna Commercial	$5.40
Rate for Payer: Aetna New Business (MI Preferred)	$4.13
Rate for Payer: Cash Price	$5.08
Rate for Payer: Cofinity Commercial	$4.44
Rate for Payer: Cofinity Commercial	$5.46
Rate for Payer: Healthscope Commercial	$5.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5.40
Rate for Payer: PHP Commercial	$5.40
Rate for Payer: Priority Health Cigna Priority Health	$4.44
Rate for Payer: Priority Health SBD	$4.00

RIVAROXABAN 20 MG TABLET

Facility

$21.15

Service Code	NDC 50458-579-10
Hospital Charge Code	155831
Hospital Revenue Code	637
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$19.04
Rate for Payer: Aetna Commercial	$17.98
Rate for Payer: Aetna New Business (MI Preferred)	$13.75
Rate for Payer: Cash Price	$16.92
Rate for Payer: Cofinity Commercial	$14.80
Rate for Payer: Cofinity Commercial	$18.19
Rate for Payer: Healthscope Commercial	$19.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.98
Rate for Payer: PHP Commercial	$17.98
Rate for Payer: Priority Health Cigna Priority Health	$14.80
Rate for Payer: Priority Health SBD	$13.32

RIVAROXABAN 2.5 MG TABLET

Facility

$21.15

Service Code	NDC 50458-577-10
Hospital Charge Code	188575
Hospital Revenue Code	637
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$19.04
Rate for Payer: Aetna Commercial	$17.98
Rate for Payer: Aetna New Business (MI Preferred)	$13.75
Rate for Payer: Cash Price	$16.92
Rate for Payer: Cofinity Commercial	$14.80
Rate for Payer: Cofinity Commercial	$18.19
Rate for Payer: Healthscope Commercial	$19.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.98
Rate for Payer: PHP Commercial	$17.98
Rate for Payer: Priority Health Cigna Priority Health	$14.80
Rate for Payer: Priority Health SBD	$13.32

RIVAROXABAN 2.5 MG TABLET

Facility

$0.22

Service Code	NDC 50458-577-01
Hospital Charge Code	188575
Hospital Revenue Code	637
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.20
Rate for Payer: Aetna Commercial	$0.19
Rate for Payer: Aetna New Business (MI Preferred)	$0.14
Rate for Payer: Cash Price	$0.18
Rate for Payer: Cofinity Commercial	$0.15
Rate for Payer: Cofinity Commercial	$0.19
Rate for Payer: Healthscope Commercial	$0.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$0.19
Rate for Payer: PHP Commercial	$0.19
Rate for Payer: Priority Health Cigna Priority Health	$0.15
Rate for Payer: Priority Health SBD	$0.14

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$253.30

Service Code	NDC 65162-749-34
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$159.58
Max. Negotiated Rate	$227.97
Rate for Payer: Aetna Commercial	$215.30
Rate for Payer: Aetna New Business (MI Preferred)	$164.64
Rate for Payer: Cash Price	$202.64
Rate for Payer: Cofinity Commercial	$177.31
Rate for Payer: Cofinity Commercial	$217.84
Rate for Payer: Healthscope Commercial	$227.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$215.30
Rate for Payer: PHP Commercial	$215.30
Rate for Payer: Priority Health Cigna Priority Health	$177.31
Rate for Payer: Priority Health SBD	$159.58

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 0078-0503-61
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$49.57
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$55.08
Rate for Payer: Priority Health SBD	$49.57

RIVASTIGMINE 13.3 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 0078-0503-15
Hospital Charge Code	162142
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,652.37
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$942.76

Service Code	NDC 0904-7107-61
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$593.94
Max. Negotiated Rate	$848.48
Rate for Payer: Aetna Commercial	$801.35
Rate for Payer: Aetna New Business (MI Preferred)	$612.79
Rate for Payer: Cash Price	$754.21
Rate for Payer: Cofinity Commercial	$659.93
Rate for Payer: Cofinity Commercial	$810.77
Rate for Payer: Healthscope Commercial	$848.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$801.35
Rate for Payer: PHP Commercial	$801.35
Rate for Payer: Priority Health Cigna Priority Health	$659.93
Rate for Payer: Priority Health SBD	$593.94

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$808.08

Service Code	NDC 63739-576-10
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$509.09
Max. Negotiated Rate	$727.27
Rate for Payer: Aetna Commercial	$686.87
Rate for Payer: Aetna New Business (MI Preferred)	$525.25
Rate for Payer: Cash Price	$646.46
Rate for Payer: Cofinity Commercial	$565.66
Rate for Payer: Cofinity Commercial	$694.95
Rate for Payer: Healthscope Commercial	$727.27
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$686.87
Rate for Payer: PHP Commercial	$686.87
Rate for Payer: Priority Health Cigna Priority Health	$565.66
Rate for Payer: Priority Health SBD	$509.09

RIVASTIGMINE 1.5 MG CAPSULE

Facility

$148.32

Service Code	NDC 55111-352-60
Hospital Charge Code	28278
Hospital Revenue Code	637
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$133.49
Rate for Payer: Aetna Commercial	$126.07
Rate for Payer: Aetna New Business (MI Preferred)	$96.41
Rate for Payer: Cash Price	$118.66
Rate for Payer: Cofinity Commercial	$103.82
Rate for Payer: Cofinity Commercial	$127.56
Rate for Payer: Healthscope Commercial	$133.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$126.07
Rate for Payer: PHP Commercial	$126.07
Rate for Payer: Priority Health Cigna Priority Health	$103.82
Rate for Payer: Priority Health SBD	$93.44

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,170.83

Service Code	NDC 47781-304-03
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$737.62
Max. Negotiated Rate	$1,053.75
Rate for Payer: Aetna Commercial	$995.21
Rate for Payer: Aetna New Business (MI Preferred)	$761.04
Rate for Payer: Cash Price	$936.66
Rate for Payer: Cofinity Commercial	$1,006.91
Rate for Payer: Cofinity Commercial	$819.58
Rate for Payer: Healthscope Commercial	$1,053.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$995.21
Rate for Payer: PHP Commercial	$995.21
Rate for Payer: Priority Health Cigna Priority Health	$819.58
Rate for Payer: Priority Health SBD	$737.62

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 0078-0501-15
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,652.37
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 4.6 MG/24 HOUR TRANSDERMAL PATCH

Facility

$39.03

Service Code	NDC 47781-304-11
Hospital Charge Code	82504
Hospital Revenue Code	637
Min. Negotiated Rate	$24.59
Max. Negotiated Rate	$35.13
Rate for Payer: Aetna Commercial	$33.18
Rate for Payer: Aetna New Business (MI Preferred)	$25.37
Rate for Payer: Cash Price	$31.22
Rate for Payer: Cofinity Commercial	$27.32
Rate for Payer: Cofinity Commercial	$33.57
Rate for Payer: Healthscope Commercial	$35.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.18
Rate for Payer: PHP Commercial	$33.18
Rate for Payer: Priority Health Cigna Priority Health	$27.32
Rate for Payer: Priority Health SBD	$24.59

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$46.52

Service Code	NDC 0781-7309-58
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$29.31
Max. Negotiated Rate	$41.87
Rate for Payer: Aetna Commercial	$39.54
Rate for Payer: Aetna New Business (MI Preferred)	$30.24
Rate for Payer: Cash Price	$37.22
Rate for Payer: Cofinity Commercial	$32.56
Rate for Payer: Cofinity Commercial	$40.01
Rate for Payer: Healthscope Commercial	$41.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$39.54
Rate for Payer: PHP Commercial	$39.54
Rate for Payer: Priority Health Cigna Priority Health	$32.56
Rate for Payer: Priority Health SBD	$29.31

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$2,360.53

Service Code	NDC 0078-0502-15
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$1,487.13
Max. Negotiated Rate	$2,124.48
Rate for Payer: Aetna Commercial	$2,006.45
Rate for Payer: Aetna New Business (MI Preferred)	$1,534.34
Rate for Payer: Cash Price	$1,888.42
Rate for Payer: Cofinity Commercial	$1,652.37
Rate for Payer: Cofinity Commercial	$2,030.06
Rate for Payer: Healthscope Commercial	$2,124.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,006.45
Rate for Payer: PHP Commercial	$2,006.45
Rate for Payer: Priority Health Cigna Priority Health	$1,652.37
Rate for Payer: Priority Health SBD	$1,487.13

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$1,395.39

Service Code	NDC 0781-7309-31
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$879.10
Max. Negotiated Rate	$1,255.85
Rate for Payer: Aetna Commercial	$1,186.08
Rate for Payer: Aetna New Business (MI Preferred)	$907.00
Rate for Payer: Cash Price	$1,116.31
Rate for Payer: Cofinity Commercial	$1,200.04
Rate for Payer: Cofinity Commercial	$976.77
Rate for Payer: Healthscope Commercial	$1,255.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,186.08
Rate for Payer: PHP Commercial	$1,186.08
Rate for Payer: Priority Health Cigna Priority Health	$976.77
Rate for Payer: Priority Health SBD	$879.10

RIVASTIGMINE 9.5 MG/24 HOUR TRANSDERMAL PATCH

Facility

$78.69

Service Code	NDC 0078-0502-61
Hospital Charge Code	82505
Hospital Revenue Code	637
Min. Negotiated Rate	$49.57
Max. Negotiated Rate	$70.82
Rate for Payer: Aetna Commercial	$66.89
Rate for Payer: Aetna New Business (MI Preferred)	$51.15
Rate for Payer: Cash Price	$62.95
Rate for Payer: Cofinity Commercial	$55.08
Rate for Payer: Cofinity Commercial	$67.67
Rate for Payer: Healthscope Commercial	$70.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$66.89
Rate for Payer: PHP Commercial	$66.89
Rate for Payer: Priority Health Cigna Priority Health	$55.08
Rate for Payer: Priority Health SBD	$49.57

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$19.67

Service Code	NDC 67457-228-05
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$12.39
Max. Negotiated Rate	$17.70
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna New Business (MI Preferred)	$12.79
Rate for Payer: Cash Price	$15.74
Rate for Payer: Cofinity Commercial	$13.77
Rate for Payer: Cofinity Commercial	$16.92
Rate for Payer: Healthscope Commercial	$17.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$16.72
Rate for Payer: PHP Commercial	$16.72
Rate for Payer: Priority Health Cigna Priority Health	$13.77
Rate for Payer: Priority Health SBD	$12.39

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$15.99

Service Code	NDC 0781-3220-95
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$14.39
Rate for Payer: Aetna Commercial	$13.59
Rate for Payer: Aetna New Business (MI Preferred)	$10.39
Rate for Payer: Cash Price	$12.79
Rate for Payer: Cofinity Commercial	$11.19
Rate for Payer: Cofinity Commercial	$13.75
Rate for Payer: Healthscope Commercial	$14.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$13.59
Rate for Payer: PHP Commercial	$13.59
Rate for Payer: Priority Health Cigna Priority Health	$11.19
Rate for Payer: Priority Health SBD	$10.07

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$17.21

Service Code	NDC 43066-007-10
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$10.84
Max. Negotiated Rate	$15.49
Rate for Payer: Aetna Commercial	$14.63
Rate for Payer: Aetna New Business (MI Preferred)	$11.19
Rate for Payer: Cash Price	$13.77
Rate for Payer: Cofinity Commercial	$12.05
Rate for Payer: Cofinity Commercial	$14.80
Rate for Payer: Healthscope Commercial	$15.49
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$14.63
Rate for Payer: PHP Commercial	$14.63
Rate for Payer: Priority Health Cigna Priority Health	$12.05
Rate for Payer: Priority Health SBD	$10.84

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$20.65

Service Code	NDC 39822-4200-1
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$18.58
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna New Business (MI Preferred)	$13.42
Rate for Payer: Cash Price	$16.52
Rate for Payer: Cofinity Commercial	$14.46
Rate for Payer: Cofinity Commercial	$17.76
Rate for Payer: Healthscope Commercial	$18.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.55
Rate for Payer: PHP Commercial	$17.55
Rate for Payer: Priority Health Cigna Priority Health	$14.46
Rate for Payer: Priority Health SBD	$13.01

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$23.49

Service Code	NDC 0409-9558-05
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$21.14
Rate for Payer: Aetna Commercial	$19.97
Rate for Payer: Aetna New Business (MI Preferred)	$15.27
Rate for Payer: Cash Price	$18.79
Rate for Payer: Cofinity Commercial	$16.44
Rate for Payer: Cofinity Commercial	$20.20
Rate for Payer: Healthscope Commercial	$21.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.97
Rate for Payer: PHP Commercial	$19.97
Rate for Payer: Priority Health Cigna Priority Health	$16.44
Rate for Payer: Priority Health SBD	$14.80

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$20.63

Service Code	NDC 0143-9250-10
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$18.57
Rate for Payer: Aetna Commercial	$17.54
Rate for Payer: Aetna New Business (MI Preferred)	$13.41
Rate for Payer: Cash Price	$16.50
Rate for Payer: Cofinity Commercial	$14.44
Rate for Payer: Cofinity Commercial	$17.74
Rate for Payer: Healthscope Commercial	$18.57
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.54
Rate for Payer: PHP Commercial	$17.54
Rate for Payer: Priority Health Cigna Priority Health	$14.44
Rate for Payer: Priority Health SBD	$13.00

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$20.65

Service Code	NDC 39822-4200-2
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$13.01
Max. Negotiated Rate	$18.58
Rate for Payer: Aetna Commercial	$17.55
Rate for Payer: Aetna New Business (MI Preferred)	$13.42
Rate for Payer: Cash Price	$16.52
Rate for Payer: Cofinity Commercial	$14.46
Rate for Payer: Cofinity Commercial	$17.76
Rate for Payer: Healthscope Commercial	$18.58
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.55
Rate for Payer: PHP Commercial	$17.55
Rate for Payer: Priority Health Cigna Priority Health	$14.46
Rate for Payer: Priority Health SBD	$13.01

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$28.13

Service Code	NDC 71288-700-05
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$17.72
Max. Negotiated Rate	$25.32
Rate for Payer: Aetna Commercial	$23.91
Rate for Payer: Aetna New Business (MI Preferred)	$18.28
Rate for Payer: Cash Price	$22.50
Rate for Payer: Cofinity Commercial	$19.69
Rate for Payer: Cofinity Commercial	$24.19
Rate for Payer: Healthscope Commercial	$25.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.91
Rate for Payer: PHP Commercial	$23.91
Rate for Payer: Priority Health Cigna Priority Health	$19.69
Rate for Payer: Priority Health SBD	$17.72

Know your out-of-pocket cost for care.

All Charges