Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$21.61

Service Code	NDC 43547-530-01
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$19.45
Rate for Payer: Aetna Commercial	$18.37
Rate for Payer: Aetna New Business (MI Preferred)	$14.05
Rate for Payer: Cash Price	$17.29
Rate for Payer: Cofinity Commercial	$15.13
Rate for Payer: Cofinity Commercial	$18.58
Rate for Payer: Healthscope Commercial	$19.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$18.37
Rate for Payer: PHP Commercial	$18.37
Rate for Payer: Priority Health Cigna Priority Health	$15.13
Rate for Payer: Priority Health SBD	$13.61

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$23.49

Service Code	NDC 0409-9558-49
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

$25.31

Service Code	NDC 47781-616-17
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$22.78
Rate for Payer: Aetna Commercial	$21.51
Rate for Payer: Aetna New Business (MI Preferred)	$16.45
Rate for Payer: Cash Price	$20.25
Rate for Payer: Cofinity Commercial	$17.72
Rate for Payer: Cofinity Commercial	$21.77
Rate for Payer: Healthscope Commercial	$22.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.51
Rate for Payer: PHP Commercial	$21.51
Rate for Payer: Priority Health Cigna Priority Health	$17.72
Rate for Payer: Priority Health SBD	$15.95

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$20.63

Service Code	NDC 0143-9250-01
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

$21.61

Service Code	NDC 43547-530-10
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$19.45
Rate for Payer: Aetna Commercial	$18.37
Rate for Payer: Aetna New Business (MI Preferred)	$14.05
Rate for Payer: Cash Price	$17.29
Rate for Payer: Cofinity Commercial	$15.13
Rate for Payer: Cofinity Commercial	$18.58
Rate for Payer: Healthscope Commercial	$19.45
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$18.37
Rate for Payer: PHP Commercial	$18.37
Rate for Payer: Priority Health Cigna Priority Health	$15.13
Rate for Payer: Priority Health SBD	$13.61

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$25.31

Service Code	NDC 47781-616-20
Hospital Charge Code	12734
Hospital Revenue Code	250
Min. Negotiated Rate	$15.95
Max. Negotiated Rate	$22.78
Rate for Payer: Aetna Commercial	$21.51
Rate for Payer: Aetna New Business (MI Preferred)	$16.45
Rate for Payer: Cash Price	$20.25
Rate for Payer: Cofinity Commercial	$17.72
Rate for Payer: Cofinity Commercial	$21.77
Rate for Payer: Healthscope Commercial	$22.78
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.51
Rate for Payer: PHP Commercial	$21.51
Rate for Payer: Priority Health Cigna Priority Health	$17.72
Rate for Payer: Priority Health SBD	$15.95

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$28.13

Service Code	NDC 71288-700-06
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

ROCURONIUM 10 MG/ML INTRAVENOUS SOLUTION

Facility

$19.67

Service Code	NDC 67457-228-00
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 IV (CODE)

Facility

$20.63

Service Code	NDC 0143-9250-10
Hospital Charge Code	163721
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 IV (CODE)

Facility

$23.49

Service Code	NDC 0409-9558-05
Hospital Charge Code	163721
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 IV (CODE)

Facility

$15.99

Service Code	NDC 0781-3220-95
Hospital Charge Code	163721
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 IV (CODE)

Facility

$20.63

Service Code	NDC 0143-9250-01
Hospital Charge Code	163721
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

ROFLUMILAST 500 MCG TABLET

Facility

$1,374.52

Service Code	NDC 0310-0095-30
Hospital Charge Code	152640
Hospital Revenue Code	637
Min. Negotiated Rate	$865.95
Max. Negotiated Rate	$1,237.07
Rate for Payer: Aetna Commercial	$1,168.34
Rate for Payer: Aetna New Business (MI Preferred)	$893.44
Rate for Payer: Cash Price	$1,099.62
Rate for Payer: Cofinity Commercial	$1,182.09
Rate for Payer: Cofinity Commercial	$962.16
Rate for Payer: Healthscope Commercial	$1,237.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,168.34
Rate for Payer: PHP Commercial	$1,168.34
Rate for Payer: Priority Health Cigna Priority Health	$962.16
Rate for Payer: Priority Health SBD	$865.95

ROFLUMILAST 500 MCG TABLET

Facility

$193.54

Service Code	NDC 68382-969-06
Hospital Charge Code	152640
Hospital Revenue Code	637
Min. Negotiated Rate	$121.93
Max. Negotiated Rate	$174.19
Rate for Payer: Aetna Commercial	$164.51
Rate for Payer: Aetna New Business (MI Preferred)	$125.80
Rate for Payer: Cash Price	$154.83
Rate for Payer: Cofinity Commercial	$135.48
Rate for Payer: Cofinity Commercial	$166.44
Rate for Payer: Healthscope Commercial	$174.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$164.51
Rate for Payer: PHP Commercial	$164.51
Rate for Payer: Priority Health Cigna Priority Health	$135.48
Rate for Payer: Priority Health SBD	$121.93

ROFLUMILAST 500 MCG TABLET

Facility

$186.77

Service Code	NDC 43547-005-03
Hospital Charge Code	152640
Hospital Revenue Code	637
Min. Negotiated Rate	$117.67
Max. Negotiated Rate	$168.09
Rate for Payer: Aetna Commercial	$158.75
Rate for Payer: Aetna New Business (MI Preferred)	$121.40
Rate for Payer: Cash Price	$149.42
Rate for Payer: Cofinity Commercial	$130.74
Rate for Payer: Cofinity Commercial	$160.62
Rate for Payer: Healthscope Commercial	$168.09
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$158.75
Rate for Payer: PHP Commercial	$158.75
Rate for Payer: Priority Health Cigna Priority Health	$130.74
Rate for Payer: Priority Health SBD	$117.67

ROMIPLOSTIM 125 MCG SUBCUTANEOUS SOLUTION

Facility

$4,006.40

Service Code	HCPCS J2796
Hospital Charge Code	192147
Hospital Revenue Code	636
Min. Negotiated Rate	$2,524.03
Max. Negotiated Rate	$3,605.76
Rate for Payer: Aetna Commercial	$3,405.44
Rate for Payer: Aetna New Business (MI Preferred)	$2,604.16
Rate for Payer: Cash Price	$3,205.12
Rate for Payer: Cofinity Commercial	$2,804.48
Rate for Payer: Cofinity Commercial	$3,445.50
Rate for Payer: Healthscope Commercial	$3,605.76
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,405.44
Rate for Payer: PHP Commercial	$3,405.44
Rate for Payer: Priority Health Cigna Priority Health	$2,804.48
Rate for Payer: Priority Health SBD	$2,524.03

ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION

Facility

$11,242.83

Service Code	HCPCS J2796
Hospital Charge Code	93566
Hospital Revenue Code	636
Min. Negotiated Rate	$7,082.98
Max. Negotiated Rate	$10,118.55
Rate for Payer: Aetna Commercial	$9,556.41
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.84
Rate for Payer: Cash Price	$8,994.26
Rate for Payer: Cofinity Commercial	$7,869.98
Rate for Payer: Cofinity Commercial	$9,668.83
Rate for Payer: Healthscope Commercial	$10,118.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9,556.41
Rate for Payer: PHP Commercial	$9,556.41
Rate for Payer: Priority Health Cigna Priority Health	$7,869.98
Rate for Payer: Priority Health SBD	$7,082.98

ROMIPLOSTIM 250 MCG SUBCUTANEOUS SOLUTION

Facility

$11,242.83

Service Code	HCPCS J2796
Hospital Charge Code	93566
Hospital Revenue Code	636
Min. Negotiated Rate	$52.53
Max. Negotiated Rate	$10,118.55
Rate for Payer: Aetna Commercial	$9,556.41
Rate for Payer: Aetna Medicare	$99.87
Rate for Payer: Aetna New Business (MI Preferred)	$7,307.84
Rate for Payer: Allen County Amish Medical Aid Commercial	$120.03
Rate for Payer: Amish Plain Church Group Commercial	$120.03
Rate for Payer: BCBS Complete	$55.16
Rate for Payer: BCBS MAPPO	$96.03
Rate for Payer: BCBS Trust/PPO	$284.26
Rate for Payer: BCN Medicare Advantage	$96.03
Rate for Payer: Cash Price	$8,994.26
Rate for Payer: Cash Price	$8,994.26
Rate for Payer: Cofinity Commercial	$9,668.83
Rate for Payer: Cofinity Commercial	$7,869.98
Rate for Payer: Health Alliance Plan Medicare Advantage	$96.03
Rate for Payer: Healthscope Commercial	$10,118.55
Rate for Payer: Mclaren Medicaid	$52.53
Rate for Payer: Mclaren Medicare	$96.03
Rate for Payer: Meridian Medicaid	$55.16
Rate for Payer: Meridian Wellcare - Medicare Advantage	$100.83
Rate for Payer: MI Amish Medical Board Commercial	$110.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$9,556.41
Rate for Payer: PACE Medicare	$91.23
Rate for Payer: PACE SWMI	$96.03
Rate for Payer: PHP Commercial	$9,556.41
Rate for Payer: PHP Medicare Advantage	$96.03
Rate for Payer: Priority Health Choice Medicaid	$52.53
Rate for Payer: Priority Health Cigna Priority Health	$7,869.98
Rate for Payer: Priority Health Medicare	$96.03
Rate for Payer: Priority Health SBD	$7,082.98
Rate for Payer: Railroad Medicare Medicare	$96.03
Rate for Payer: UHC Dual Complete DSNP	$96.03
Rate for Payer: UHC Medicare Advantage	$98.91
Rate for Payer: VA VA	$96.03

ROMIPLOSTIM 500 MCG SUBCUTANEOUS SOLUTION

Facility

$13,020.62

Service Code	HCPCS J2796
Hospital Charge Code	93567
Hospital Revenue Code	636
Min. Negotiated Rate	$8,202.99
Max. Negotiated Rate	$11,718.56
Rate for Payer: Aetna Commercial	$11,067.53
Rate for Payer: Aetna New Business (MI Preferred)	$8,463.40
Rate for Payer: Cash Price	$10,416.50
Rate for Payer: Cofinity Commercial	$11,197.73
Rate for Payer: Cofinity Commercial	$9,114.43
Rate for Payer: Healthscope Commercial	$11,718.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11,067.53
Rate for Payer: PHP Commercial	$11,067.53
Rate for Payer: Priority Health Cigna Priority Health	$9,114.43
Rate for Payer: Priority Health SBD	$8,202.99

ROMOSOZUMAB-AQQG 210 MG/2.34 ML(105 MG/1.17 ML X2)SUBCUTANEOUS SYRINGE

Facility

$3,894.98

Service Code	HCPCS J3111
Hospital Charge Code	190169
Hospital Revenue Code	636
Min. Negotiated Rate	$2,453.84
Max. Negotiated Rate	$3,505.48
Rate for Payer: Aetna Commercial	$3,310.73
Rate for Payer: Aetna New Business (MI Preferred)	$2,531.74
Rate for Payer: Cash Price	$3,115.98
Rate for Payer: Cofinity Commercial	$3,349.68
Rate for Payer: Cofinity Commercial	$2,726.49
Rate for Payer: Healthscope Commercial	$3,505.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3,310.73
Rate for Payer: PHP Commercial	$3,310.73
Rate for Payer: Priority Health Cigna Priority Health	$2,726.49
Rate for Payer: Priority Health SBD	$2,453.84

ROPINIROLE 0.25 MG TABLET

Facility

$323.00

Service Code	NDC 0904-6373-61
Hospital Charge Code	21688
Hospital Revenue Code	637
Min. Negotiated Rate	$203.49
Max. Negotiated Rate	$290.70
Rate for Payer: Aetna Commercial	$274.55
Rate for Payer: Aetna New Business (MI Preferred)	$209.95
Rate for Payer: Cash Price	$258.40
Rate for Payer: Cofinity Commercial	$277.78
Rate for Payer: Cofinity Commercial	$226.10
Rate for Payer: Healthscope Commercial	$290.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$274.55
Rate for Payer: PHP Commercial	$274.55
Rate for Payer: Priority Health Cigna Priority Health	$226.10
Rate for Payer: Priority Health SBD	$203.49

ROPINIROLE 0.5 MG TABLET

Facility

$267.90

Service Code	NDC 68462-254-01
Hospital Charge Code	21800
Hospital Revenue Code	637
Min. Negotiated Rate	$168.78
Max. Negotiated Rate	$241.11
Rate for Payer: Aetna Commercial	$227.72
Rate for Payer: Aetna New Business (MI Preferred)	$174.14
Rate for Payer: Cash Price	$214.32
Rate for Payer: Cofinity Commercial	$187.53
Rate for Payer: Cofinity Commercial	$230.39
Rate for Payer: Healthscope Commercial	$241.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$227.72
Rate for Payer: PHP Commercial	$227.72
Rate for Payer: Priority Health Cigna Priority Health	$187.53
Rate for Payer: Priority Health SBD	$168.78

ROPINIROLE 0.5 MG TABLET

Facility

$124.55

Service Code	NDC 43547-269-10
Hospital Charge Code	21800
Hospital Revenue Code	637
Min. Negotiated Rate	$78.47
Max. Negotiated Rate	$112.10
Rate for Payer: Aetna Commercial	$105.87
Rate for Payer: Aetna New Business (MI Preferred)	$80.96
Rate for Payer: Cash Price	$99.64
Rate for Payer: Cofinity Commercial	$107.11
Rate for Payer: Cofinity Commercial	$87.18
Rate for Payer: Healthscope Commercial	$112.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$105.87
Rate for Payer: PHP Commercial	$105.87
Rate for Payer: Priority Health Cigna Priority Health	$87.18
Rate for Payer: Priority Health SBD	$78.47

ROPINIROLE 2 MG TABLET

Facility

$163.40

Service Code	NDC 50268-744-15
Hospital Charge Code	21690
Hospital Revenue Code	637
Min. Negotiated Rate	$102.94
Max. Negotiated Rate	$147.06
Rate for Payer: Aetna Commercial	$138.89
Rate for Payer: Aetna New Business (MI Preferred)	$106.21
Rate for Payer: Cash Price	$130.72
Rate for Payer: Cofinity Commercial	$114.38
Rate for Payer: Cofinity Commercial	$140.52
Rate for Payer: Healthscope Commercial	$147.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$138.89
Rate for Payer: PHP Commercial	$138.89
Rate for Payer: Priority Health Cigna Priority Health	$114.38
Rate for Payer: Priority Health SBD	$102.94

ROPINIROLE 2 MG TABLET

Facility

$3.27

Service Code	NDC 50268-744-11
Hospital Charge Code	21690
Hospital Revenue Code	637
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.94
Rate for Payer: Aetna Commercial	$2.78
Rate for Payer: Aetna New Business (MI Preferred)	$2.13
Rate for Payer: Cash Price	$2.62
Rate for Payer: Cofinity Commercial	$2.29
Rate for Payer: Cofinity Commercial	$2.81
Rate for Payer: Healthscope Commercial	$2.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.78
Rate for Payer: PHP Commercial	$2.78
Rate for Payer: Priority Health Cigna Priority Health	$2.29
Rate for Payer: Priority Health SBD	$2.06

Know your out-of-pocket cost for care.

All Charges