Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$105.05

Service Code	NDC 16729044410
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$42.02
Max. Negotiated Rate	$94.54
Rate for Payer: Aetna Commercial	$89.29
Rate for Payer: Aetna Medicare	$52.52
Rate for Payer: Aetna New Business (MI Preferred)	$68.28
Rate for Payer: BCBS Complete	$42.02
Rate for Payer: Cash Price	$84.04
Rate for Payer: Cofinity Commercial	$73.54
Rate for Payer: Cofinity Commercial	$90.34
Rate for Payer: Cofinity Medicare Advantage	$73.54
Rate for Payer: Encore Health Key Benefits Commercial	$84.04
Rate for Payer: Healthscope Commercial	$94.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.29
Rate for Payer: PHP Commercial	$89.29
Rate for Payer: Priority Health Cigna Priority Health	$68.28
Rate for Payer: Priority Health SBD	$66.18

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$418.77

Service Code	NDC 68180032009
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$263.83
Max. Negotiated Rate	$376.89
Rate for Payer: Aetna Commercial	$355.95
Rate for Payer: Aetna New Business (MI Preferred)	$272.20
Rate for Payer: Cash Price	$335.02
Rate for Payer: Cofinity Commercial	$293.14
Rate for Payer: Cofinity Commercial	$360.14
Rate for Payer: Cofinity Medicare Advantage	$293.14
Rate for Payer: Encore Health Key Benefits Commercial	$335.02
Rate for Payer: Healthscope Commercial	$376.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$355.95
Rate for Payer: PHP Commercial	$355.95
Rate for Payer: Priority Health Cigna Priority Health	$272.20
Rate for Payer: Priority Health SBD	$263.83

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$158.55

Service Code	NDC 00904657304
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$99.89
Max. Negotiated Rate	$142.70
Rate for Payer: Aetna Commercial	$134.77
Rate for Payer: Aetna New Business (MI Preferred)	$103.06
Rate for Payer: Cash Price	$126.84
Rate for Payer: Cofinity Commercial	$110.98
Rate for Payer: Cofinity Commercial	$136.35
Rate for Payer: Cofinity Medicare Advantage	$110.98
Rate for Payer: Encore Health Key Benefits Commercial	$126.84
Rate for Payer: Healthscope Commercial	$142.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$134.77
Rate for Payer: PHP Commercial	$134.77
Rate for Payer: Priority Health Cigna Priority Health	$103.06
Rate for Payer: Priority Health SBD	$99.89

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$418.77

Service Code	NDC 68180032009
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$167.51
Max. Negotiated Rate	$376.89
Rate for Payer: Aetna Commercial	$355.95
Rate for Payer: Aetna Medicare	$209.38
Rate for Payer: Aetna New Business (MI Preferred)	$272.20
Rate for Payer: BCBS Complete	$167.51
Rate for Payer: Cash Price	$335.02
Rate for Payer: Cofinity Commercial	$293.14
Rate for Payer: Cofinity Commercial	$360.14
Rate for Payer: Cofinity Medicare Advantage	$293.14
Rate for Payer: Encore Health Key Benefits Commercial	$335.02
Rate for Payer: Healthscope Commercial	$376.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$355.95
Rate for Payer: PHP Commercial	$355.95
Rate for Payer: Priority Health Cigna Priority Health	$272.20
Rate for Payer: Priority Health SBD	$263.83

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$249.60

Service Code	NDC 50268014115
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$99.84
Max. Negotiated Rate	$224.64
Rate for Payer: Aetna Commercial	$212.16
Rate for Payer: Aetna Medicare	$124.80
Rate for Payer: Aetna New Business (MI Preferred)	$162.24
Rate for Payer: BCBS Complete	$99.84
Rate for Payer: Cash Price	$199.68
Rate for Payer: Cofinity Commercial	$174.72
Rate for Payer: Cofinity Commercial	$214.66
Rate for Payer: Cofinity Medicare Advantage	$174.72
Rate for Payer: Encore Health Key Benefits Commercial	$199.68
Rate for Payer: Healthscope Commercial	$224.64
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$212.16
Rate for Payer: PHP Commercial	$212.16
Rate for Payer: Priority Health Cigna Priority Health	$162.24
Rate for Payer: Priority Health SBD	$157.25

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$215.00

Service Code	NDC 60687079321
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$86.00
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$182.75
Rate for Payer: Aetna Medicare	$107.50
Rate for Payer: Aetna New Business (MI Preferred)	$139.75
Rate for Payer: BCBS Complete	$86.00
Rate for Payer: Cash Price	$172.00
Rate for Payer: Cofinity Commercial	$150.50
Rate for Payer: Cofinity Commercial	$184.90
Rate for Payer: Cofinity Medicare Advantage	$150.50
Rate for Payer: Encore Health Key Benefits Commercial	$172.00
Rate for Payer: Healthscope Commercial	$193.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.75
Rate for Payer: PHP Commercial	$182.75
Rate for Payer: Priority Health Cigna Priority Health	$139.75
Rate for Payer: Priority Health SBD	$135.45

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$133.95

Service Code	NDC 68180032006
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$84.39
Max. Negotiated Rate	$120.56
Rate for Payer: Aetna Commercial	$113.86
Rate for Payer: Aetna New Business (MI Preferred)	$87.07
Rate for Payer: Cash Price	$107.16
Rate for Payer: Cofinity Commercial	$115.20
Rate for Payer: Cofinity Commercial	$93.76
Rate for Payer: Cofinity Medicare Advantage	$93.76
Rate for Payer: Encore Health Key Benefits Commercial	$107.16
Rate for Payer: Healthscope Commercial	$120.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$113.86
Rate for Payer: PHP Commercial	$113.86
Rate for Payer: Priority Health Cigna Priority Health	$87.07
Rate for Payer: Priority Health SBD	$84.39

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$5.00

Service Code	NDC 50268014111
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna Medicare	$2.50
Rate for Payer: Aetna New Business (MI Preferred)	$3.25
Rate for Payer: BCBS Complete	$2.00
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Cofinity Commercial	$4.30
Rate for Payer: Cofinity Medicare Advantage	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$4.00
Rate for Payer: Healthscope Commercial	$4.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.25
Rate for Payer: PHP Commercial	$4.25
Rate for Payer: Priority Health Cigna Priority Health	$3.25
Rate for Payer: Priority Health SBD	$3.15

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$5.00

Service Code	NDC 50268014111
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$4.25
Rate for Payer: Aetna New Business (MI Preferred)	$3.25
Rate for Payer: Cash Price	$4.00
Rate for Payer: Cofinity Commercial	$3.50
Rate for Payer: Cofinity Commercial	$4.30
Rate for Payer: Cofinity Medicare Advantage	$3.50
Rate for Payer: Encore Health Key Benefits Commercial	$4.00
Rate for Payer: Healthscope Commercial	$4.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.25
Rate for Payer: PHP Commercial	$4.25
Rate for Payer: Priority Health Cigna Priority Health	$3.25
Rate for Payer: Priority Health SBD	$3.15

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$327.83

Service Code	NDC 24979010207
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$131.13
Max. Negotiated Rate	$295.05
Rate for Payer: Aetna Commercial	$278.66
Rate for Payer: Aetna Medicare	$163.92
Rate for Payer: Aetna New Business (MI Preferred)	$213.09
Rate for Payer: BCBS Complete	$131.13
Rate for Payer: Cash Price	$262.26
Rate for Payer: Cofinity Commercial	$229.48
Rate for Payer: Cofinity Commercial	$281.93
Rate for Payer: Cofinity Medicare Advantage	$229.48
Rate for Payer: Encore Health Key Benefits Commercial	$262.26
Rate for Payer: Healthscope Commercial	$295.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$278.66
Rate for Payer: PHP Commercial	$278.66
Rate for Payer: Priority Health Cigna Priority Health	$213.09
Rate for Payer: Priority Health SBD	$206.53

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$327.83

Service Code	NDC 24979010207
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$206.53
Max. Negotiated Rate	$295.05
Rate for Payer: Aetna Commercial	$278.66
Rate for Payer: Aetna New Business (MI Preferred)	$213.09
Rate for Payer: Cash Price	$262.26
Rate for Payer: Cofinity Commercial	$229.48
Rate for Payer: Cofinity Commercial	$281.93
Rate for Payer: Cofinity Medicare Advantage	$229.48
Rate for Payer: Encore Health Key Benefits Commercial	$262.26
Rate for Payer: Healthscope Commercial	$295.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$278.66
Rate for Payer: PHP Commercial	$278.66
Rate for Payer: Priority Health Cigna Priority Health	$213.09
Rate for Payer: Priority Health SBD	$206.53

BUPROPION HCL XL 300 MG 24 HR TABLET, EXTENDED RELEASE

Facility

$215.00

Service Code	NDC 60687079321
Hospital Charge Code	36776
Hospital Revenue Code	637
Min. Negotiated Rate	$135.45
Max. Negotiated Rate	$193.50
Rate for Payer: Aetna Commercial	$182.75
Rate for Payer: Aetna New Business (MI Preferred)	$139.75
Rate for Payer: Cash Price	$172.00
Rate for Payer: Cofinity Commercial	$150.50
Rate for Payer: Cofinity Commercial	$184.90
Rate for Payer: Cofinity Medicare Advantage	$150.50
Rate for Payer: Encore Health Key Benefits Commercial	$172.00
Rate for Payer: Healthscope Commercial	$193.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$182.75
Rate for Payer: PHP Commercial	$182.75
Rate for Payer: Priority Health Cigna Priority Health	$139.75
Rate for Payer: Priority Health SBD	$135.45

BUSPIRONE 10 MG TABLET

Facility

$124.55

Service Code	NDC 23155002401
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$49.82
Max. Negotiated Rate	$112.10
Rate for Payer: Aetna Commercial	$105.87
Rate for Payer: Aetna Medicare	$62.28
Rate for Payer: Aetna New Business (MI Preferred)	$80.96
Rate for Payer: BCBS Complete	$49.82
Rate for Payer: Cash Price	$99.64
Rate for Payer: Cofinity Commercial	$107.11
Rate for Payer: Cofinity Commercial	$87.18
Rate for Payer: Cofinity Medicare Advantage	$87.18
Rate for Payer: Encore Health Key Benefits Commercial	$99.64
Rate for Payer: Healthscope Commercial	$112.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.87
Rate for Payer: PHP Commercial	$105.87
Rate for Payer: Priority Health Cigna Priority Health	$80.96
Rate for Payer: Priority Health SBD	$78.47

BUSPIRONE 10 MG TABLET

Facility

$340.75

Service Code	NDC 51079098620
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$136.30
Max. Negotiated Rate	$306.68
Rate for Payer: Aetna Commercial	$289.64
Rate for Payer: Aetna Medicare	$170.38
Rate for Payer: Aetna New Business (MI Preferred)	$221.49
Rate for Payer: BCBS Complete	$136.30
Rate for Payer: Cash Price	$272.60
Rate for Payer: Cofinity Commercial	$238.52
Rate for Payer: Cofinity Commercial	$293.04
Rate for Payer: Cofinity Medicare Advantage	$238.52
Rate for Payer: Encore Health Key Benefits Commercial	$272.60
Rate for Payer: Healthscope Commercial	$306.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$289.64
Rate for Payer: PHP Commercial	$289.64
Rate for Payer: Priority Health Cigna Priority Health	$221.49
Rate for Payer: Priority Health SBD	$214.67

BUSPIRONE 10 MG TABLET

Facility

$96.35

Service Code	NDC 16729020201
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$60.70
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$81.90
Rate for Payer: Aetna New Business (MI Preferred)	$62.63
Rate for Payer: Cash Price	$77.08
Rate for Payer: Cofinity Commercial	$67.44
Rate for Payer: Cofinity Commercial	$82.86
Rate for Payer: Cofinity Medicare Advantage	$67.44
Rate for Payer: Encore Health Key Benefits Commercial	$77.08
Rate for Payer: Healthscope Commercial	$86.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$81.90
Rate for Payer: PHP Commercial	$81.90
Rate for Payer: Priority Health Cigna Priority Health	$62.63
Rate for Payer: Priority Health SBD	$60.70

BUSPIRONE 10 MG TABLET

Facility

$340.75

Service Code	NDC 51079098620
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$214.67
Max. Negotiated Rate	$306.68
Rate for Payer: Aetna Commercial	$289.64
Rate for Payer: Aetna New Business (MI Preferred)	$221.49
Rate for Payer: Cash Price	$272.60
Rate for Payer: Cofinity Commercial	$238.52
Rate for Payer: Cofinity Commercial	$293.04
Rate for Payer: Cofinity Medicare Advantage	$238.52
Rate for Payer: Encore Health Key Benefits Commercial	$272.60
Rate for Payer: Healthscope Commercial	$306.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$289.64
Rate for Payer: PHP Commercial	$289.64
Rate for Payer: Priority Health Cigna Priority Health	$221.49
Rate for Payer: Priority Health SBD	$214.67

BUSPIRONE 10 MG TABLET

Facility

$124.55

Service Code	NDC 23155002401
Hospital Charge Code	9323
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: Cofinity Medicare Advantage	$87.18
Rate for Payer: Encore Health Key Benefits Commercial	$99.64
Rate for Payer: Healthscope Commercial	$112.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$105.87
Rate for Payer: PHP Commercial	$105.87
Rate for Payer: Priority Health Cigna Priority Health	$80.96
Rate for Payer: Priority Health SBD	$78.47

BUSPIRONE 10 MG TABLET

Facility

$145.70

Service Code	NDC 24689090701
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$58.28
Max. Negotiated Rate	$131.13
Rate for Payer: Aetna Commercial	$123.84
Rate for Payer: Aetna Medicare	$72.85
Rate for Payer: Aetna New Business (MI Preferred)	$94.70
Rate for Payer: BCBS Complete	$58.28
Rate for Payer: Cash Price	$116.56
Rate for Payer: Cofinity Commercial	$101.99
Rate for Payer: Cofinity Commercial	$125.30
Rate for Payer: Cofinity Medicare Advantage	$101.99
Rate for Payer: Encore Health Key Benefits Commercial	$116.56
Rate for Payer: Healthscope Commercial	$131.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.84
Rate for Payer: PHP Commercial	$123.84
Rate for Payer: Priority Health Cigna Priority Health	$94.70
Rate for Payer: Priority Health SBD	$91.79

BUSPIRONE 10 MG TABLET

Facility

$96.35

Service Code	NDC 16729020201
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$38.54
Max. Negotiated Rate	$86.72
Rate for Payer: Aetna Commercial	$81.90
Rate for Payer: Aetna Medicare	$48.18
Rate for Payer: Aetna New Business (MI Preferred)	$62.63
Rate for Payer: BCBS Complete	$38.54
Rate for Payer: Cash Price	$77.08
Rate for Payer: Cofinity Commercial	$67.44
Rate for Payer: Cofinity Commercial	$82.86
Rate for Payer: Cofinity Medicare Advantage	$67.44
Rate for Payer: Encore Health Key Benefits Commercial	$77.08
Rate for Payer: Healthscope Commercial	$86.72
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$81.90
Rate for Payer: PHP Commercial	$81.90
Rate for Payer: Priority Health Cigna Priority Health	$62.63
Rate for Payer: Priority Health SBD	$60.70

BUSPIRONE 10 MG TABLET

Facility

$145.70

Service Code	NDC 24689090701
Hospital Charge Code	9323
Hospital Revenue Code	637
Min. Negotiated Rate	$91.79
Max. Negotiated Rate	$131.13
Rate for Payer: Aetna Commercial	$123.84
Rate for Payer: Aetna New Business (MI Preferred)	$94.70
Rate for Payer: Cash Price	$116.56
Rate for Payer: Cofinity Commercial	$101.99
Rate for Payer: Cofinity Commercial	$125.30
Rate for Payer: Cofinity Medicare Advantage	$101.99
Rate for Payer: Encore Health Key Benefits Commercial	$116.56
Rate for Payer: Healthscope Commercial	$131.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$123.84
Rate for Payer: PHP Commercial	$123.84
Rate for Payer: Priority Health Cigna Priority Health	$94.70
Rate for Payer: Priority Health SBD	$91.79

BUSPIRONE 15 MG TABLET

Facility

$4.56

Service Code	NDC 51079096001
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$4.10
Rate for Payer: Aetna Commercial	$3.88
Rate for Payer: Aetna Medicare	$2.28
Rate for Payer: Aetna New Business (MI Preferred)	$2.96
Rate for Payer: BCBS Complete	$1.82
Rate for Payer: Cash Price	$3.65
Rate for Payer: Cofinity Commercial	$3.19
Rate for Payer: Cofinity Commercial	$3.92
Rate for Payer: Cofinity Medicare Advantage	$3.19
Rate for Payer: Encore Health Key Benefits Commercial	$3.65
Rate for Payer: Healthscope Commercial	$4.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.88
Rate for Payer: PHP Commercial	$3.88
Rate for Payer: Priority Health Cigna Priority Health	$2.96
Rate for Payer: Priority Health SBD	$2.87

BUSPIRONE 15 MG TABLET

Facility

$455.05

Service Code	NDC 51079096020
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$286.68
Max. Negotiated Rate	$409.54
Rate for Payer: Aetna Commercial	$386.79
Rate for Payer: Aetna New Business (MI Preferred)	$295.78
Rate for Payer: Cash Price	$364.04
Rate for Payer: Cofinity Commercial	$318.54
Rate for Payer: Cofinity Commercial	$391.34
Rate for Payer: Cofinity Medicare Advantage	$318.54
Rate for Payer: Encore Health Key Benefits Commercial	$364.04
Rate for Payer: Healthscope Commercial	$409.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$386.79
Rate for Payer: PHP Commercial	$386.79
Rate for Payer: Priority Health Cigna Priority Health	$295.78
Rate for Payer: Priority Health SBD	$286.68

BUSPIRONE 15 MG TABLET

Facility

$4.56

Service Code	NDC 51079096001
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$2.87
Max. Negotiated Rate	$4.10
Rate for Payer: Aetna Commercial	$3.88
Rate for Payer: Aetna New Business (MI Preferred)	$2.96
Rate for Payer: Cash Price	$3.65
Rate for Payer: Cofinity Commercial	$3.19
Rate for Payer: Cofinity Commercial	$3.92
Rate for Payer: Cofinity Medicare Advantage	$3.19
Rate for Payer: Encore Health Key Benefits Commercial	$3.65
Rate for Payer: Healthscope Commercial	$4.10
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.88
Rate for Payer: PHP Commercial	$3.88
Rate for Payer: Priority Health Cigna Priority Health	$2.96
Rate for Payer: Priority Health SBD	$2.87

BUSPIRONE 15 MG TABLET

Facility

$455.05

Service Code	NDC 51079096020
Hospital Charge Code	17464
Hospital Revenue Code	637
Min. Negotiated Rate	$182.02
Max. Negotiated Rate	$409.54
Rate for Payer: Aetna Commercial	$386.79
Rate for Payer: Aetna Medicare	$227.52
Rate for Payer: Aetna New Business (MI Preferred)	$295.78
Rate for Payer: BCBS Complete	$182.02
Rate for Payer: Cash Price	$364.04
Rate for Payer: Cofinity Commercial	$318.54
Rate for Payer: Cofinity Commercial	$391.34
Rate for Payer: Cofinity Medicare Advantage	$318.54
Rate for Payer: Encore Health Key Benefits Commercial	$364.04
Rate for Payer: Healthscope Commercial	$409.54
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$386.79
Rate for Payer: PHP Commercial	$386.79
Rate for Payer: Priority Health Cigna Priority Health	$295.78
Rate for Payer: Priority Health SBD	$286.68

BUSPIRONE 5 MG TABLET

Facility

$105.75

Service Code	NDC 68382018001
Hospital Charge Code	9324
Hospital Revenue Code	637
Min. Negotiated Rate	$42.30
Max. Negotiated Rate	$95.18
Rate for Payer: Aetna Commercial	$89.89
Rate for Payer: Aetna Medicare	$52.88
Rate for Payer: Aetna New Business (MI Preferred)	$68.74
Rate for Payer: BCBS Complete	$42.30
Rate for Payer: Cash Price	$84.60
Rate for Payer: Cofinity Commercial	$74.02
Rate for Payer: Cofinity Commercial	$90.94
Rate for Payer: Cofinity Medicare Advantage	$74.02
Rate for Payer: Encore Health Key Benefits Commercial	$84.60
Rate for Payer: Healthscope Commercial	$95.18
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.89
Rate for Payer: PHP Commercial	$89.89
Rate for Payer: Priority Health Cigna Priority Health	$68.74
Rate for Payer: Priority Health SBD	$66.62

Know your out-of-pocket cost for care.

All Charges