Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 211
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 218
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 212
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 214
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 219
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 215
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SNF Bill Type

Facility

$893.00

Service Code	LOCAL 217
Min. Negotiated Rate	$893.00
Max. Negotiated Rate	$893.00
Rate for Payer: UHC Exchange	$893.00

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION

Facility

$20.72

Service Code	NDC 0409-7299-73
Hospital Charge Code	7301
Hospital Revenue Code	250
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$18.65
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna New Business (MI Preferred)	$13.47
Rate for Payer: Cash Price	$16.58
Rate for Payer: Cofinity Commercial	$14.50
Rate for Payer: Cofinity Commercial	$17.82
Rate for Payer: Healthscope Commercial	$18.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.61
Rate for Payer: PHP Commercial	$17.61
Rate for Payer: Priority Health Cigna Priority Health	$14.50
Rate for Payer: Priority Health SBD	$13.05

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION

Facility

$20.72

Service Code	NDC 0409-7299-83
Hospital Charge Code	7301
Hospital Revenue Code	250
Min. Negotiated Rate	$13.05
Max. Negotiated Rate	$18.65
Rate for Payer: Aetna Commercial	$17.61
Rate for Payer: Aetna New Business (MI Preferred)	$13.47
Rate for Payer: Cash Price	$16.58
Rate for Payer: Cofinity Commercial	$14.50
Rate for Payer: Cofinity Commercial	$17.82
Rate for Payer: Healthscope Commercial	$18.65
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$17.61
Rate for Payer: PHP Commercial	$17.61
Rate for Payer: Priority Health Cigna Priority Health	$14.50
Rate for Payer: Priority Health SBD	$13.05

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION

Facility

$18.03

Service Code	NDC 0409-3299-05
Hospital Charge Code	7301
Hospital Revenue Code	250
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$16.23
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna New Business (MI Preferred)	$11.72
Rate for Payer: Cash Price	$14.42
Rate for Payer: Cofinity Commercial	$12.62
Rate for Payer: Cofinity Commercial	$15.51
Rate for Payer: Healthscope Commercial	$16.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.33
Rate for Payer: PHP Commercial	$15.33
Rate for Payer: Priority Health Cigna Priority Health	$12.62
Rate for Payer: Priority Health SBD	$11.36

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION

Facility

$18.03

Service Code	NDC 0409-3299-15
Hospital Charge Code	7301
Hospital Revenue Code	250
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$16.23
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna New Business (MI Preferred)	$11.72
Rate for Payer: Cash Price	$14.42
Rate for Payer: Cofinity Commercial	$12.62
Rate for Payer: Cofinity Commercial	$15.51
Rate for Payer: Healthscope Commercial	$16.23
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$15.33
Rate for Payer: PHP Commercial	$15.33
Rate for Payer: Priority Health Cigna Priority Health	$12.62
Rate for Payer: Priority Health SBD	$11.36

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION

Facility

$24.92

Service Code	NDC 0409-3299-06
Hospital Charge Code	7301
Hospital Revenue Code	250
Min. Negotiated Rate	$15.70
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$21.18
Rate for Payer: Aetna New Business (MI Preferred)	$16.20
Rate for Payer: Cash Price	$19.94
Rate for Payer: Cofinity Commercial	$17.44
Rate for Payer: Cofinity Commercial	$21.43
Rate for Payer: Healthscope Commercial	$22.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$21.18
Rate for Payer: PHP Commercial	$21.18
Rate for Payer: Priority Health Cigna Priority Health	$17.44
Rate for Payer: Priority Health SBD	$15.70

SODIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION (TPN COMPONENT)

Facility

$62.30

Service Code	NDC 9900-0019-16
Hospital Charge Code	300441
Hospital Revenue Code	250
Min. Negotiated Rate	$39.25
Max. Negotiated Rate	$56.07
Rate for Payer: Aetna Commercial	$52.96
Rate for Payer: Aetna New Business (MI Preferred)	$40.50
Rate for Payer: Cash Price	$49.84
Rate for Payer: Cofinity Commercial	$43.61
Rate for Payer: Cofinity Commercial	$53.58
Rate for Payer: Healthscope Commercial	$56.07
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$52.96
Rate for Payer: PHP Commercial	$52.96
Rate for Payer: Priority Health Cigna Priority Health	$43.61
Rate for Payer: Priority Health SBD	$39.25

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$23.81

Service Code	NDC 51754-5001-5
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$21.43
Rate for Payer: Aetna Commercial	$20.24
Rate for Payer: Aetna New Business (MI Preferred)	$15.48
Rate for Payer: Cash Price	$19.05
Rate for Payer: Cofinity Commercial	$16.67
Rate for Payer: Cofinity Commercial	$20.48
Rate for Payer: Healthscope Commercial	$21.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$20.24
Rate for Payer: PHP Commercial	$20.24
Rate for Payer: Priority Health Cigna Priority Health	$16.67
Rate for Payer: Priority Health SBD	$15.00

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$35.83

Service Code	NDC 0409-6625-02
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$32.25
Rate for Payer: Aetna Commercial	$30.46
Rate for Payer: Aetna New Business (MI Preferred)	$23.29
Rate for Payer: Cash Price	$28.66
Rate for Payer: Cofinity Commercial	$25.08
Rate for Payer: Cofinity Commercial	$30.81
Rate for Payer: Healthscope Commercial	$32.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.46
Rate for Payer: PHP Commercial	$30.46
Rate for Payer: Priority Health Cigna Priority Health	$25.08
Rate for Payer: Priority Health SBD	$22.57

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$22.70

Service Code	NDC 51754-5001-1
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$19.30
Rate for Payer: Aetna New Business (MI Preferred)	$14.76
Rate for Payer: Cash Price	$18.16
Rate for Payer: Cofinity Commercial	$15.89
Rate for Payer: Cofinity Commercial	$19.52
Rate for Payer: Healthscope Commercial	$20.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.30
Rate for Payer: PHP Commercial	$19.30
Rate for Payer: Priority Health Cigna Priority Health	$15.89
Rate for Payer: Priority Health SBD	$14.30

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$90.12

Service Code	NDC 63323-089-50
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$56.78
Max. Negotiated Rate	$81.11
Rate for Payer: Aetna Commercial	$76.60
Rate for Payer: Aetna New Business (MI Preferred)	$58.58
Rate for Payer: Cash Price	$72.10
Rate for Payer: Cofinity Commercial	$63.08
Rate for Payer: Cofinity Commercial	$77.50
Rate for Payer: Healthscope Commercial	$81.11
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$76.60
Rate for Payer: PHP Commercial	$76.60
Rate for Payer: Priority Health Cigna Priority Health	$63.08
Rate for Payer: Priority Health SBD	$56.78

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$35.60

Service Code	NDC 0409-6625-14
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$22.43
Max. Negotiated Rate	$32.04
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna New Business (MI Preferred)	$23.14
Rate for Payer: Cash Price	$28.48
Rate for Payer: Cofinity Commercial	$24.92
Rate for Payer: Cofinity Commercial	$30.62
Rate for Payer: Healthscope Commercial	$32.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.26
Rate for Payer: PHP Commercial	$30.26
Rate for Payer: Priority Health Cigna Priority Health	$24.92
Rate for Payer: Priority Health SBD	$22.43

SODIUM BICARBONATE 1 MEQ/ML (8.4 %) INTRAVENOUS SOLUTION

Facility

$35.60

Service Code	NDC 0409-6625-22
Hospital Charge Code	108819
Hospital Revenue Code	250
Min. Negotiated Rate	$22.43
Max. Negotiated Rate	$32.04
Rate for Payer: Aetna Commercial	$30.26
Rate for Payer: Aetna New Business (MI Preferred)	$23.14
Rate for Payer: Cash Price	$28.48
Rate for Payer: Cofinity Commercial	$24.92
Rate for Payer: Cofinity Commercial	$30.62
Rate for Payer: Healthscope Commercial	$32.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$30.26
Rate for Payer: PHP Commercial	$30.26
Rate for Payer: Priority Health Cigna Priority Health	$24.92
Rate for Payer: Priority Health SBD	$22.43

SODIUM BICARBONATE 650 MG TABLET

Facility

$282.00

Service Code	NDC 77333-827-10
Hospital Charge Code	7312
Hospital Revenue Code	637
Min. Negotiated Rate	$177.66
Max. Negotiated Rate	$253.80
Rate for Payer: Aetna Commercial	$239.70
Rate for Payer: Aetna New Business (MI Preferred)	$183.30
Rate for Payer: Cash Price	$225.60
Rate for Payer: Cofinity Commercial	$197.40
Rate for Payer: Cofinity Commercial	$242.52
Rate for Payer: Healthscope Commercial	$253.80
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$239.70
Rate for Payer: PHP Commercial	$239.70
Rate for Payer: Priority Health Cigna Priority Health	$197.40
Rate for Payer: Priority Health SBD	$177.66

SODIUM BICARBONATE 650 MG TABLET

Facility

$2.78

Service Code	NDC 7733383125
Hospital Charge Code	7312
Hospital Revenue Code	637
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$2.36
Rate for Payer: Aetna New Business (MI Preferred)	$1.81
Rate for Payer: Cash Price	$2.22
Rate for Payer: Cofinity Commercial	$1.95
Rate for Payer: Cofinity Commercial	$2.39
Rate for Payer: Healthscope Commercial	$2.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.36
Rate for Payer: PHP Commercial	$2.36
Rate for Payer: Priority Health Cigna Priority Health	$1.95
Rate for Payer: Priority Health SBD	$1.75

SODIUM BICARBONATE 650 MG TABLET

Facility

$2.82

Service Code	NDC 77333-827-25
Hospital Charge Code	7312
Hospital Revenue Code	637
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$2.54
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna New Business (MI Preferred)	$1.83
Rate for Payer: Cash Price	$2.26
Rate for Payer: Cofinity Commercial	$1.97
Rate for Payer: Cofinity Commercial	$2.43
Rate for Payer: Healthscope Commercial	$2.54
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.40
Rate for Payer: PHP Commercial	$2.40
Rate for Payer: Priority Health Cigna Priority Health	$1.97
Rate for Payer: Priority Health SBD	$1.78

SODIUM BICARBONATE 650 MG TABLET

Facility

$277.30

Service Code	NDC 7733383110
Hospital Charge Code	7312
Hospital Revenue Code	637
Min. Negotiated Rate	$174.70
Max. Negotiated Rate	$249.57
Rate for Payer: Aetna Commercial	$235.70
Rate for Payer: Aetna New Business (MI Preferred)	$180.24
Rate for Payer: Cash Price	$221.84
Rate for Payer: Cofinity Commercial	$194.11
Rate for Payer: Cofinity Commercial	$238.48
Rate for Payer: Healthscope Commercial	$249.57
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$235.70
Rate for Payer: PHP Commercial	$235.70
Rate for Payer: Priority Health Cigna Priority Health	$194.11
Rate for Payer: Priority Health SBD	$174.70

SODIUM BICARBONATE 650 MG TABLET

Facility

$235.00

Service Code	NDC 64980-528-10
Hospital Charge Code	7312
Hospital Revenue Code	637
Min. Negotiated Rate	$148.05
Max. Negotiated Rate	$211.50
Rate for Payer: Aetna Commercial	$199.75
Rate for Payer: Aetna New Business (MI Preferred)	$152.75
Rate for Payer: Cash Price	$188.00
Rate for Payer: Cofinity Commercial	$164.50
Rate for Payer: Cofinity Commercial	$202.10
Rate for Payer: Healthscope Commercial	$211.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$199.75
Rate for Payer: PHP Commercial	$199.75
Rate for Payer: Priority Health Cigna Priority Health	$164.50
Rate for Payer: Priority Health SBD	$148.05

SODIUM BICARBONATE 8.4 % (1 MEQ/ML) INTRAVENOUS SYRINGE

Facility

$40.28

Service Code	NDC 0409-6637-34
Hospital Charge Code	7309
Hospital Revenue Code	250
Min. Negotiated Rate	$25.38
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$34.24
Rate for Payer: Aetna New Business (MI Preferred)	$26.18
Rate for Payer: Cash Price	$32.22
Rate for Payer: Cofinity Commercial	$28.20
Rate for Payer: Cofinity Commercial	$34.64
Rate for Payer: Healthscope Commercial	$36.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$34.24
Rate for Payer: PHP Commercial	$34.24
Rate for Payer: Priority Health Cigna Priority Health	$28.20
Rate for Payer: Priority Health SBD	$25.38

Know your out-of-pocket cost for care.

All Charges