Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

VORICONAZOLE 200 MG TABLET

Facility

$385.40

Service Code	NDC 0049-3180-30
Hospital Charge Code	33009
Hospital Revenue Code	637
Min. Negotiated Rate	$242.80
Max. Negotiated Rate	$346.86
Rate for Payer: Aetna Commercial	$327.59
Rate for Payer: Aetna New Business (MI Preferred)	$250.51
Rate for Payer: Cash Price	$308.32
Rate for Payer: Cofinity Commercial	$331.44
Rate for Payer: Cofinity Commercial	$269.78
Rate for Payer: Healthscope Commercial	$346.86
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$327.59
Rate for Payer: PHP Commercial	$327.59
Rate for Payer: Priority Health Cigna Priority Health	$269.78
Rate for Payer: Priority Health SBD	$242.80

VORICONAZOLE 200 MG TABLET

Facility

$180.58

Service Code	NDC 27241-063-03
Hospital Charge Code	33009
Hospital Revenue Code	637
Min. Negotiated Rate	$113.77
Max. Negotiated Rate	$162.52
Rate for Payer: Aetna Commercial	$153.49
Rate for Payer: Aetna New Business (MI Preferred)	$117.38
Rate for Payer: Cash Price	$144.46
Rate for Payer: Cofinity Commercial	$126.41
Rate for Payer: Cofinity Commercial	$155.30
Rate for Payer: Healthscope Commercial	$162.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$153.49
Rate for Payer: PHP Commercial	$153.49
Rate for Payer: Priority Health Cigna Priority Health	$126.41
Rate for Payer: Priority Health SBD	$113.77

VORTIOXETINE 10 MG TABLET

Facility

$1,684.98

Service Code	NDC 64764-730-30
Hospital Charge Code	168416
Hospital Revenue Code	637
Min. Negotiated Rate	$1,061.54
Max. Negotiated Rate	$1,516.48
Rate for Payer: Aetna Commercial	$1,432.23
Rate for Payer: Aetna New Business (MI Preferred)	$1,095.24
Rate for Payer: Cash Price	$1,347.98
Rate for Payer: Cofinity Commercial	$1,179.49
Rate for Payer: Cofinity Commercial	$1,449.08
Rate for Payer: Healthscope Commercial	$1,516.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,432.23
Rate for Payer: PHP Commercial	$1,432.23
Rate for Payer: Priority Health Cigna Priority Health	$1,179.49
Rate for Payer: Priority Health SBD	$1,061.54

VORTIOXETINE 5 MG TABLET

Facility

$1,684.98

Service Code	NDC 64764-720-30
Hospital Charge Code	168415
Hospital Revenue Code	637
Min. Negotiated Rate	$1,061.54
Max. Negotiated Rate	$1,516.48
Rate for Payer: Aetna Commercial	$1,432.23
Rate for Payer: Aetna New Business (MI Preferred)	$1,095.24
Rate for Payer: Cash Price	$1,347.98
Rate for Payer: Cofinity Commercial	$1,449.08
Rate for Payer: Cofinity Commercial	$1,179.49
Rate for Payer: Healthscope Commercial	$1,516.48
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1,432.23
Rate for Payer: PHP Commercial	$1,432.23
Rate for Payer: Priority Health Cigna Priority Health	$1,179.49
Rate for Payer: Priority Health SBD	$1,061.54

WARFARIN 10 MG TABLET

Facility

$2.04

Service Code	NDC 0832-1219-89
Hospital Charge Code	8748
Hospital Revenue Code	637
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.84
Rate for Payer: Aetna Commercial	$1.73
Rate for Payer: Aetna New Business (MI Preferred)	$1.33
Rate for Payer: Cash Price	$1.63
Rate for Payer: Cofinity Commercial	$1.43
Rate for Payer: Cofinity Commercial	$1.75
Rate for Payer: Healthscope Commercial	$1.84
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.73
Rate for Payer: PHP Commercial	$1.73
Rate for Payer: Priority Health Cigna Priority Health	$1.43
Rate for Payer: Priority Health SBD	$1.29

WARFARIN 10 MG TABLET

Facility

$203.30

Service Code	NDC 0832-1219-01
Hospital Charge Code	8748
Hospital Revenue Code	637
Min. Negotiated Rate	$128.08
Max. Negotiated Rate	$182.97
Rate for Payer: Aetna Commercial	$172.80
Rate for Payer: Aetna New Business (MI Preferred)	$132.14
Rate for Payer: Cash Price	$162.64
Rate for Payer: Cofinity Commercial	$142.31
Rate for Payer: Cofinity Commercial	$174.84
Rate for Payer: Healthscope Commercial	$182.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$172.80
Rate for Payer: PHP Commercial	$172.80
Rate for Payer: Priority Health Cigna Priority Health	$142.31
Rate for Payer: Priority Health SBD	$128.08

WARFARIN 10 MG TABLET

Facility

$317.25

Service Code	NDC 0093-1720-01
Hospital Charge Code	8748
Hospital Revenue Code	637
Min. Negotiated Rate	$199.87
Max. Negotiated Rate	$285.52
Rate for Payer: Aetna Commercial	$269.66
Rate for Payer: Aetna New Business (MI Preferred)	$206.21
Rate for Payer: Cash Price	$253.80
Rate for Payer: Cofinity Commercial	$222.08
Rate for Payer: Cofinity Commercial	$272.84
Rate for Payer: Healthscope Commercial	$285.52
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$269.66
Rate for Payer: PHP Commercial	$269.66
Rate for Payer: Priority Health Cigna Priority Health	$222.08
Rate for Payer: Priority Health SBD	$199.87

WARFARIN 1 MG TABLET

Facility

$361.90

Service Code	NDC 0832-1211-01
Hospital Charge Code	11664
Hospital Revenue Code	637
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$325.71
Rate for Payer: Aetna Commercial	$307.62
Rate for Payer: Aetna New Business (MI Preferred)	$235.24
Rate for Payer: Cash Price	$289.52
Rate for Payer: Cofinity Commercial	$253.33
Rate for Payer: Cofinity Commercial	$311.23
Rate for Payer: Healthscope Commercial	$325.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$307.62
Rate for Payer: PHP Commercial	$307.62
Rate for Payer: Priority Health Cigna Priority Health	$253.33
Rate for Payer: Priority Health SBD	$228.00

WARFARIN 1 MG TABLET

Facility

$275.50

Service Code	NDC 51672-4027-1
Hospital Charge Code	11664
Hospital Revenue Code	637
Min. Negotiated Rate	$173.56
Max. Negotiated Rate	$247.95
Rate for Payer: Aetna Commercial	$234.18
Rate for Payer: Aetna New Business (MI Preferred)	$179.08
Rate for Payer: Cash Price	$220.40
Rate for Payer: Cofinity Commercial	$192.85
Rate for Payer: Cofinity Commercial	$236.93
Rate for Payer: Healthscope Commercial	$247.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$234.18
Rate for Payer: PHP Commercial	$234.18
Rate for Payer: Priority Health Cigna Priority Health	$192.85
Rate for Payer: Priority Health SBD	$173.56

WARFARIN 1 MG TABLET

Facility

$173.90

Service Code	NDC 0093-1712-01
Hospital Charge Code	11664
Hospital Revenue Code	637
Min. Negotiated Rate	$109.56
Max. Negotiated Rate	$156.51
Rate for Payer: Aetna Commercial	$147.82
Rate for Payer: Aetna New Business (MI Preferred)	$113.04
Rate for Payer: Cash Price	$139.12
Rate for Payer: Cofinity Commercial	$121.73
Rate for Payer: Cofinity Commercial	$149.55
Rate for Payer: Healthscope Commercial	$156.51
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$147.82
Rate for Payer: PHP Commercial	$147.82
Rate for Payer: Priority Health Cigna Priority Health	$121.73
Rate for Payer: Priority Health SBD	$109.56

WARFARIN 1 MG TABLET

Facility

$3.62

Service Code	NDC 0832-1211-89
Hospital Charge Code	11664
Hospital Revenue Code	637
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$3.26
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.35
Rate for Payer: Cash Price	$2.90
Rate for Payer: Cofinity Commercial	$2.53
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Healthscope Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.08
Rate for Payer: PHP Commercial	$3.08
Rate for Payer: Priority Health Cigna Priority Health	$2.53
Rate for Payer: Priority Health SBD	$2.28

WARFARIN 2.5 MG TABLET

Facility

$3.62

Service Code	NDC 0832-1213-89
Hospital Charge Code	8750
Hospital Revenue Code	637
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$3.26
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.35
Rate for Payer: Cash Price	$2.90
Rate for Payer: Cofinity Commercial	$2.53
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Healthscope Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.08
Rate for Payer: PHP Commercial	$3.08
Rate for Payer: Priority Health Cigna Priority Health	$2.53
Rate for Payer: Priority Health SBD	$2.28

WARFARIN 2.5 MG TABLET

Facility

$361.90

Service Code	NDC 0832-1213-01
Hospital Charge Code	8750
Hospital Revenue Code	637
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$325.71
Rate for Payer: Aetna Commercial	$307.62
Rate for Payer: Aetna New Business (MI Preferred)	$235.24
Rate for Payer: Cash Price	$289.52
Rate for Payer: Cofinity Commercial	$253.33
Rate for Payer: Cofinity Commercial	$311.23
Rate for Payer: Healthscope Commercial	$325.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$307.62
Rate for Payer: PHP Commercial	$307.62
Rate for Payer: Priority Health Cigna Priority Health	$253.33
Rate for Payer: Priority Health SBD	$228.00

WARFARIN 2.5 MG TABLET

Facility

$219.45

Service Code	NDC 68084-027-01
Hospital Charge Code	8750
Hospital Revenue Code	637
Min. Negotiated Rate	$138.25
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$186.53
Rate for Payer: Aetna New Business (MI Preferred)	$142.64
Rate for Payer: Cash Price	$175.56
Rate for Payer: Cofinity Commercial	$153.62
Rate for Payer: Cofinity Commercial	$188.73
Rate for Payer: Healthscope Commercial	$197.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$186.53
Rate for Payer: PHP Commercial	$186.53
Rate for Payer: Priority Health Cigna Priority Health	$153.62
Rate for Payer: Priority Health SBD	$138.25

WARFARIN 2.5 MG TABLET

Facility

$219.45

Service Code	NDC 68084-027-11
Hospital Charge Code	8750
Hospital Revenue Code	637
Min. Negotiated Rate	$138.25
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$186.53
Rate for Payer: Aetna New Business (MI Preferred)	$142.64
Rate for Payer: Cash Price	$175.56
Rate for Payer: Cofinity Commercial	$153.62
Rate for Payer: Cofinity Commercial	$188.73
Rate for Payer: Healthscope Commercial	$197.50
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$186.53
Rate for Payer: PHP Commercial	$186.53
Rate for Payer: Priority Health Cigna Priority Health	$153.62
Rate for Payer: Priority Health SBD	$138.25

WARFARIN 2 MG TABLET

Facility

$190.35

Service Code	NDC 0093-1713-01
Hospital Charge Code	8749
Hospital Revenue Code	637
Min. Negotiated Rate	$119.92
Max. Negotiated Rate	$171.32
Rate for Payer: Aetna Commercial	$161.80
Rate for Payer: Aetna New Business (MI Preferred)	$123.73
Rate for Payer: Cash Price	$152.28
Rate for Payer: Cofinity Commercial	$133.24
Rate for Payer: Cofinity Commercial	$163.70
Rate for Payer: Healthscope Commercial	$171.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$161.80
Rate for Payer: PHP Commercial	$161.80
Rate for Payer: Priority Health Cigna Priority Health	$133.24
Rate for Payer: Priority Health SBD	$119.92

WARFARIN 5 MG TABLET

Facility

$2.28

Service Code	NDC 62584-994-11
Hospital Charge Code	8751
Hospital Revenue Code	637
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$2.05
Rate for Payer: Aetna Commercial	$1.94
Rate for Payer: Aetna New Business (MI Preferred)	$1.48
Rate for Payer: Cash Price	$1.82
Rate for Payer: Cofinity Commercial	$1.60
Rate for Payer: Cofinity Commercial	$1.96
Rate for Payer: Healthscope Commercial	$2.05
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$1.94
Rate for Payer: PHP Commercial	$1.94
Rate for Payer: Priority Health Cigna Priority Health	$1.60
Rate for Payer: Priority Health SBD	$1.44

WARFARIN 5 MG TABLET

Facility

$3.62

Service Code	NDC 0832-1216-89
Hospital Charge Code	8751
Hospital Revenue Code	637
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$3.26
Rate for Payer: Aetna Commercial	$3.08
Rate for Payer: Aetna New Business (MI Preferred)	$2.35
Rate for Payer: Cash Price	$2.90
Rate for Payer: Cofinity Commercial	$2.53
Rate for Payer: Cofinity Commercial	$3.11
Rate for Payer: Healthscope Commercial	$3.26
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$3.08
Rate for Payer: PHP Commercial	$3.08
Rate for Payer: Priority Health Cigna Priority Health	$2.53
Rate for Payer: Priority Health SBD	$2.28

WARFARIN 5 MG TABLET

Facility

$361.90

Service Code	NDC 0832-1216-01
Hospital Charge Code	8751
Hospital Revenue Code	637
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$325.71
Rate for Payer: Aetna Commercial	$307.62
Rate for Payer: Aetna New Business (MI Preferred)	$235.24
Rate for Payer: Cash Price	$289.52
Rate for Payer: Cofinity Commercial	$253.33
Rate for Payer: Cofinity Commercial	$311.23
Rate for Payer: Healthscope Commercial	$325.71
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$307.62
Rate for Payer: PHP Commercial	$307.62
Rate for Payer: Priority Health Cigna Priority Health	$253.33
Rate for Payer: Priority Health SBD	$228.00

WARFARIN 5 MG TABLET

Facility

$228.00

Service Code	NDC 62584-994-01
Hospital Charge Code	8751
Hospital Revenue Code	637
Min. Negotiated Rate	$143.64
Max. Negotiated Rate	$205.20
Rate for Payer: Aetna Commercial	$193.80
Rate for Payer: Aetna New Business (MI Preferred)	$148.20
Rate for Payer: Cash Price	$182.40
Rate for Payer: Cofinity Commercial	$159.60
Rate for Payer: Cofinity Commercial	$196.08
Rate for Payer: Healthscope Commercial	$205.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$193.80
Rate for Payer: PHP Commercial	$193.80
Rate for Payer: Priority Health Cigna Priority Health	$159.60
Rate for Payer: Priority Health SBD	$143.64

WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION

Facility

$39.00

Service Code	NDC 0409-3977-03
Hospital Charge Code	864
Hospital Revenue Code	250
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$35.10
Rate for Payer: Aetna Commercial	$33.15
Rate for Payer: Aetna New Business (MI Preferred)	$25.35
Rate for Payer: Cash Price	$31.20
Rate for Payer: Cofinity Commercial	$27.30
Rate for Payer: Cofinity Commercial	$33.54
Rate for Payer: Healthscope Commercial	$35.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.15
Rate for Payer: PHP Commercial	$33.15
Rate for Payer: Priority Health Cigna Priority Health	$27.30
Rate for Payer: Priority Health SBD	$24.57

WATER FOR INJECTION, BACTERIOSTATIC INJECTION SOLUTION

Facility

$39.00

Service Code	NDC 0409-3977-01
Hospital Charge Code	864
Hospital Revenue Code	250
Min. Negotiated Rate	$24.57
Max. Negotiated Rate	$35.10
Rate for Payer: Aetna Commercial	$33.15
Rate for Payer: Aetna New Business (MI Preferred)	$25.35
Rate for Payer: Cash Price	$31.20
Rate for Payer: Cofinity Commercial	$27.30
Rate for Payer: Cofinity Commercial	$33.54
Rate for Payer: Healthscope Commercial	$35.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$33.15
Rate for Payer: PHP Commercial	$33.15
Rate for Payer: Priority Health Cigna Priority Health	$27.30
Rate for Payer: Priority Health SBD	$24.57

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$26.83

Service Code	NDC 0409-4887-24
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$24.15
Rate for Payer: Aetna Commercial	$22.81
Rate for Payer: Aetna New Business (MI Preferred)	$17.44
Rate for Payer: Cash Price	$21.46
Rate for Payer: Cofinity Commercial	$18.78
Rate for Payer: Cofinity Commercial	$23.07
Rate for Payer: Healthscope Commercial	$24.15
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$22.81
Rate for Payer: PHP Commercial	$22.81
Rate for Payer: Priority Health Cigna Priority Health	$18.78
Rate for Payer: Priority Health SBD	$16.90

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$14.79

Service Code	NDC 0409-4887-20
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$13.31
Rate for Payer: Aetna Commercial	$12.57
Rate for Payer: Aetna New Business (MI Preferred)	$9.61
Rate for Payer: Cash Price	$11.83
Rate for Payer: Cofinity Commercial	$10.35
Rate for Payer: Cofinity Commercial	$12.72
Rate for Payer: Healthscope Commercial	$13.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$12.57
Rate for Payer: PHP Commercial	$12.57
Rate for Payer: Priority Health Cigna Priority Health	$10.35
Rate for Payer: Priority Health SBD	$9.32

WATER FOR INJECTION, STERILE INJECTION SOLUTION

Facility

$13.75

Service Code	NDC 0409-4887-17
Hospital Charge Code	11671
Hospital Revenue Code	250
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$12.38
Rate for Payer: Aetna Commercial	$11.69
Rate for Payer: Aetna New Business (MI Preferred)	$8.94
Rate for Payer: BCBS Complete	$5.50
Rate for Payer: Cash Price	$11.00
Rate for Payer: Cofinity Commercial	$11.82
Rate for Payer: Cofinity Commercial	$9.62
Rate for Payer: Healthscope Commercial	$12.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$11.69
Rate for Payer: PHP Commercial	$11.69
Rate for Payer: Priority Health Cigna Priority Health	$9.62
Rate for Payer: Priority Health SBD	$8.66

Know your out-of-pocket cost for care.

All Charges