Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

THERMAGE ABDOMEN - ENTIRE

Professional

Both

$3,100.00

Service Code	HCPCS 00150
Hospital Revenue Code	960
Min. Negotiated Rate	$1,240.00
Max. Negotiated Rate	$2,170.00
Rate for Payer: BCBS Complete	$1,240.00
Rate for Payer: Cash Price	$2,480.00
Rate for Payer: Priority Health Cigna Priority Health	$2,170.00

THERMAGE ABDOMEN - LOWER

Professional

Both

$2,000.00

Service Code	HCPCS 00149
Hospital Revenue Code	960
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: BCBS Complete	$800.00
Rate for Payer: Cash Price	$1,600.00
Rate for Payer: Priority Health Cigna Priority Health	$1,400.00

THERMAGE ARMS - 1 ARM

Professional

Both

$1,200.00

Service Code	HCPCS 00145
Hospital Revenue Code	960
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$840.00
Rate for Payer: BCBS Complete	$480.00
Rate for Payer: Cash Price	$960.00
Rate for Payer: Priority Health Cigna Priority Health	$840.00

THERMAGE ARMS - BILATERAL

Professional

Both

$2,100.00

Service Code	HCPCS 00146
Hospital Revenue Code	960
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,470.00
Rate for Payer: BCBS Complete	$840.00
Rate for Payer: Cash Price	$1,680.00
Rate for Payer: Priority Health Cigna Priority Health	$1,470.00

THERMAGE EYES

Professional

Both

$950.00

Service Code	HCPCS 00140
Hospital Revenue Code	960
Min. Negotiated Rate	$380.00
Max. Negotiated Rate	$665.00
Rate for Payer: BCBS Complete	$380.00
Rate for Payer: Cash Price	$760.00
Rate for Payer: Priority Health Cigna Priority Health	$665.00

THERMAGE FACE

Professional

Both

$2,000.00

Service Code	HCPCS 00139
Hospital Revenue Code	960
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$1,400.00
Rate for Payer: BCBS Complete	$800.00
Rate for Payer: Cash Price	$1,600.00
Rate for Payer: Priority Health Cigna Priority Health	$1,400.00

THERMAGE FACE & EYES

Professional

Both

$2,700.00

Service Code	HCPCS 00142
Hospital Revenue Code	960
Min. Negotiated Rate	$1,080.00
Max. Negotiated Rate	$1,890.00
Rate for Payer: BCBS Complete	$1,080.00
Rate for Payer: Cash Price	$2,160.00
Rate for Payer: Priority Health Cigna Priority Health	$1,890.00

THERMAGE FACE & NECK

Professional

Both

$2,800.00

Service Code	HCPCS 00143
Hospital Revenue Code	960
Min. Negotiated Rate	$1,120.00
Max. Negotiated Rate	$1,960.00
Rate for Payer: BCBS Complete	$1,120.00
Rate for Payer: Cash Price	$2,240.00
Rate for Payer: Priority Health Cigna Priority Health	$1,960.00

THERMAGE FACE, NECK, & EYES

Professional

Both

$3,500.00

Service Code	HCPCS 00144
Hospital Revenue Code	960
Min. Negotiated Rate	$1,400.00
Max. Negotiated Rate	$2,450.00
Rate for Payer: BCBS Complete	$1,400.00
Rate for Payer: Cash Price	$2,800.00
Rate for Payer: Priority Health Cigna Priority Health	$2,450.00

THERMAGE KNEES - BILATERAL

Professional

Both

$1,200.00

Service Code	HCPCS 00151
Hospital Revenue Code	960
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$840.00
Rate for Payer: BCBS Complete	$480.00
Rate for Payer: Cash Price	$960.00
Rate for Payer: Priority Health Cigna Priority Health	$840.00

THERMAGE NECK

Professional

Both

$1,200.00

Service Code	HCPCS 00141
Hospital Revenue Code	960
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$840.00
Rate for Payer: BCBS Complete	$480.00
Rate for Payer: Cash Price	$960.00
Rate for Payer: Priority Health Cigna Priority Health	$840.00

THERMAGE THIGH - 1 THIGH

Professional

Both

$1,900.00

Service Code	HCPCS 00147
Hospital Revenue Code	960
Min. Negotiated Rate	$760.00
Max. Negotiated Rate	$1,330.00
Rate for Payer: BCBS Complete	$760.00
Rate for Payer: Cash Price	$1,520.00
Rate for Payer: Priority Health Cigna Priority Health	$1,330.00

THERMAGE THIGH - BILATERAL

Professional

Both

$3,100.00

Service Code	HCPCS 00148
Hospital Revenue Code	960
Min. Negotiated Rate	$1,240.00
Max. Negotiated Rate	$2,170.00
Rate for Payer: BCBS Complete	$1,240.00
Rate for Payer: Cash Price	$2,480.00
Rate for Payer: Priority Health Cigna Priority Health	$2,170.00

THIAMINE HCL (VITAMIN B1) 100 MG/ML INJECTION SOLUTION

Facility

$22.84

Service Code	HCPCS J3411
Hospital Charge Code	7876
Hospital Revenue Code	636
Min. Negotiated Rate	$14.39
Max. Negotiated Rate	$20.56
Rate for Payer: Aetna Commercial	$19.41
Rate for Payer: Aetna Commercial	$23.40
Rate for Payer: Aetna Commercial	$23.05
Rate for Payer: Aetna Commercial	$24.00
Rate for Payer: Aetna Commercial	$22.00
Rate for Payer: Aetna New Business (MI Preferred)	$17.63
Rate for Payer: Aetna New Business (MI Preferred)	$14.85
Rate for Payer: Aetna New Business (MI Preferred)	$18.35
Rate for Payer: Aetna New Business (MI Preferred)	$16.82
Rate for Payer: Aetna New Business (MI Preferred)	$17.89
Rate for Payer: Cash Price	$20.70
Rate for Payer: Cash Price	$22.02
Rate for Payer: Cash Price	$21.70
Rate for Payer: Cash Price	$18.27
Rate for Payer: Cash Price	$22.58
Rate for Payer: Cofinity Commercial	$19.64
Rate for Payer: Cofinity Commercial	$15.99
Rate for Payer: Cofinity Commercial	$18.12
Rate for Payer: Cofinity Commercial	$22.26
Rate for Payer: Cofinity Commercial	$18.98
Rate for Payer: Cofinity Commercial	$23.32
Rate for Payer: Cofinity Commercial	$19.27
Rate for Payer: Cofinity Commercial	$23.68
Rate for Payer: Cofinity Commercial	$19.76
Rate for Payer: Cofinity Commercial	$24.28
Rate for Payer: Healthscope Commercial	$24.78
Rate for Payer: Healthscope Commercial	$24.41
Rate for Payer: Healthscope Commercial	$23.29
Rate for Payer: Healthscope Commercial	$25.41
Rate for Payer: Healthscope Commercial	$20.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$23.40
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$19.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$24.00
Rate for Payer: PHP Commercial	$24.00
Rate for Payer: PHP Commercial	$23.05
Rate for Payer: PHP Commercial	$22.00
Rate for Payer: PHP Commercial	$23.40
Rate for Payer: PHP Commercial	$19.41
Rate for Payer: Priority Health Cigna Priority Health	$18.12
Rate for Payer: Priority Health Cigna Priority Health	$19.27
Rate for Payer: Priority Health Cigna Priority Health	$18.98
Rate for Payer: Priority Health Cigna Priority Health	$19.76
Rate for Payer: Priority Health Cigna Priority Health	$15.99
Rate for Payer: Priority Health SBD	$17.09
Rate for Payer: Priority Health SBD	$17.34
Rate for Payer: Priority Health SBD	$16.30
Rate for Payer: Priority Health SBD	$14.39
Rate for Payer: Priority Health SBD	$17.78

THIAMINE HCL (VITAMIN B1) 100 MG TABLET

Facility

$3.55

Service Code	NDC 5026885111
Hospital Charge Code	7877
Hospital Revenue Code	637
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$3.20
Rate for Payer: Aetna Commercial	$3.02
Rate for Payer: Aetna New Business (MI Preferred)	$2.31
Rate for Payer: Cash Price	$2.84
Rate for Payer: Cofinity Commercial	$3.05
Rate for Payer: Cofinity Commercial	$2.48
Rate for Payer: Healthscope Commercial	$3.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.02
Rate for Payer: PHP Commercial	$3.02
Rate for Payer: Priority Health Cigna Priority Health	$2.48
Rate for Payer: Priority Health SBD	$2.24

THIAMINE HCL (VITAMIN B1) 100 MG TABLET

Facility

$105.75

Service Code	NDC 7985420010
Hospital Charge Code	7877
Hospital Revenue Code	637
Min. Negotiated Rate	$66.62
Max. Negotiated Rate	$95.18
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna New Business (MI Preferred)	$68.74
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cofinity Commercial	$74.02
Rate for Payer: Cofinity Commercial	$90.94
Rate for Payer: Healthscope Commercial	$95.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$89.89
Rate for Payer: PHP Commercial	$89.89
Rate for Payer: Priority Health Cigna Priority Health	$74.02
Rate for Payer: Priority Health SBD	$66.62

THIAMINE HCL (VITAMIN B1) 100 MG TABLET

Facility

$177.43

Service Code	NDC 5026885115
Hospital Charge Code	7877
Hospital Revenue Code	637
Min. Negotiated Rate	$111.78
Max. Negotiated Rate	$159.69
Rate for Payer: Aetna Commercial	$150.82
Rate for Payer: Aetna New Business (MI Preferred)	$115.33
Rate for Payer: Cash Price	$141.94
Rate for Payer: Cofinity Commercial	$124.20
Rate for Payer: Cofinity Commercial	$152.59
Rate for Payer: Healthscope Commercial	$159.69
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$150.82
Rate for Payer: PHP Commercial	$150.82
Rate for Payer: Priority Health Cigna Priority Health	$124.20
Rate for Payer: Priority Health SBD	$111.78

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET

Facility

$411.25

Service Code	NDC 6809411661
Hospital Charge Code	119871
Hospital Revenue Code	637
Min. Negotiated Rate	$259.09
Max. Negotiated Rate	$370.12
Rate for Payer: Aetna Commercial	$349.56
Rate for Payer: Aetna New Business (MI Preferred)	$267.31
Rate for Payer: Cash Price	$329.00
Rate for Payer: Cofinity Commercial	$353.68
Rate for Payer: Cofinity Commercial	$287.88
Rate for Payer: Healthscope Commercial	$370.12
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$349.56
Rate for Payer: PHP Commercial	$349.56
Rate for Payer: Priority Health Cigna Priority Health	$287.88
Rate for Payer: Priority Health SBD	$259.09

THIAMINE MONONITRATE (VITAMIN B1) 100 MG TABLET

Facility

$4.12

Service Code	NDC 6809411659
Hospital Charge Code	119871
Hospital Revenue Code	637
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$3.71
Rate for Payer: Aetna Commercial	$3.50
Rate for Payer: Aetna New Business (MI Preferred)	$2.68
Rate for Payer: Cash Price	$3.30
Rate for Payer: Cofinity Commercial	$2.88
Rate for Payer: Cofinity Commercial	$3.54
Rate for Payer: Healthscope Commercial	$3.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.50
Rate for Payer: PHP Commercial	$3.50
Rate for Payer: Priority Health Cigna Priority Health	$2.88
Rate for Payer: Priority Health SBD	$2.60

THIORIDAZINE 100 MG TABLET

Facility

$426.24

Service Code	NDC 0378-0618-01
Hospital Charge Code	7895
Hospital Revenue Code	637
Min. Negotiated Rate	$268.53
Max. Negotiated Rate	$383.62
Rate for Payer: Aetna Commercial	$362.30
Rate for Payer: Aetna New Business (MI Preferred)	$277.06
Rate for Payer: Cash Price	$340.99
Rate for Payer: Cofinity Commercial	$298.37
Rate for Payer: Cofinity Commercial	$366.57
Rate for Payer: Healthscope Commercial	$383.62
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$362.30
Rate for Payer: PHP Commercial	$362.30
Rate for Payer: Priority Health Cigna Priority Health	$298.37
Rate for Payer: Priority Health SBD	$268.53

THIORIDAZINE 100 MG TABLET

Facility

$3.38

Service Code	NDC 51079-580-01
Hospital Charge Code	7895
Hospital Revenue Code	637
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$3.04
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna New Business (MI Preferred)	$2.20
Rate for Payer: Cash Price	$2.70
Rate for Payer: Cofinity Commercial	$2.37
Rate for Payer: Cofinity Commercial	$2.91
Rate for Payer: Healthscope Commercial	$3.04
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2.87
Rate for Payer: PHP Commercial	$2.87
Rate for Payer: Priority Health Cigna Priority Health	$2.37
Rate for Payer: Priority Health SBD	$2.13

THIORIDAZINE 100 MG TABLET

Facility

$337.44

Service Code	NDC 51079-580-20
Hospital Charge Code	7895
Hospital Revenue Code	637
Min. Negotiated Rate	$212.59
Max. Negotiated Rate	$303.70
Rate for Payer: Aetna Commercial	$286.82
Rate for Payer: Aetna New Business (MI Preferred)	$219.34
Rate for Payer: Cash Price	$269.95
Rate for Payer: Cofinity Commercial	$236.21
Rate for Payer: Cofinity Commercial	$290.20
Rate for Payer: Healthscope Commercial	$303.70
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$286.82
Rate for Payer: PHP Commercial	$286.82
Rate for Payer: Priority Health Cigna Priority Health	$236.21
Rate for Payer: Priority Health SBD	$212.59

THIORIDAZINE 25 MG TABLET

Facility

$468.35

Service Code	NDC 51079-566-20
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$295.06
Max. Negotiated Rate	$421.52
Rate for Payer: Aetna Commercial	$398.10
Rate for Payer: Aetna New Business (MI Preferred)	$304.43
Rate for Payer: Cash Price	$374.68
Rate for Payer: Cofinity Commercial	$327.84
Rate for Payer: Cofinity Commercial	$402.78
Rate for Payer: Healthscope Commercial	$421.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$398.10
Rate for Payer: PHP Commercial	$398.10
Rate for Payer: Priority Health Cigna Priority Health	$327.84
Rate for Payer: Priority Health SBD	$295.06

THIORIDAZINE 25 MG TABLET

Facility

$4.69

Service Code	NDC 51079-566-01
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$4.22
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna New Business (MI Preferred)	$3.05
Rate for Payer: Cash Price	$3.75
Rate for Payer: Cofinity Commercial	$3.28
Rate for Payer: Cofinity Commercial	$4.03
Rate for Payer: Healthscope Commercial	$4.22
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.99
Rate for Payer: PHP Commercial	$3.99
Rate for Payer: Priority Health Cigna Priority Health	$3.28
Rate for Payer: Priority Health SBD	$2.95

THIORIDAZINE 25 MG TABLET

Facility

$299.04

Service Code	NDC 0378-0614-01
Hospital Charge Code	7899
Hospital Revenue Code	637
Min. Negotiated Rate	$188.40
Max. Negotiated Rate	$269.14
Rate for Payer: Aetna Commercial	$254.18
Rate for Payer: Aetna New Business (MI Preferred)	$194.38
Rate for Payer: Cash Price	$239.23
Rate for Payer: Cofinity Commercial	$209.33
Rate for Payer: Cofinity Commercial	$257.17
Rate for Payer: Healthscope Commercial	$269.14
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$254.18
Rate for Payer: PHP Commercial	$254.18
Rate for Payer: Priority Health Cigna Priority Health	$209.33
Rate for Payer: Priority Health SBD	$188.40

Know your out-of-pocket cost for care.

All Charges