|
ROPIVACAINE (PF) 5 MG/ML (0.5 %) INJECTION SOLUTION
|
Facility
|
IP
|
$25.31
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
153276
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$22.78 |
| Rate for Payer: Aetna Commercial |
$21.51
|
| Rate for Payer: Aetna Commercial |
$21.14
|
| Rate for Payer: Aetna Commercial |
$17.48
|
| Rate for Payer: Aetna Commercial |
$28.14
|
| Rate for Payer: Aetna Commercial |
$28.60
|
| Rate for Payer: Aetna Commercial |
$19.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.87
|
| Rate for Payer: Cash Price |
$16.45
|
| Rate for Payer: Cash Price |
$18.30
|
| Rate for Payer: Cash Price |
$26.49
|
| Rate for Payer: Cash Price |
$26.92
|
| Rate for Payer: Cash Price |
$19.90
|
| Rate for Payer: Cash Price |
$20.25
|
| Rate for Payer: Cofinity Advantage |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$17.41
|
| Rate for Payer: Cofinity Advantage |
$17.72
|
| Rate for Payer: Cofinity Advantage |
$16.01
|
| Rate for Payer: Cofinity Advantage |
$14.39
|
| Rate for Payer: Cofinity Advantage |
$23.55
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$21.39
|
| Rate for Payer: Cofinity Commercial |
$19.67
|
| Rate for Payer: Cofinity Commercial |
$17.68
|
| Rate for Payer: Cofinity Commercial |
$28.47
|
| Rate for Payer: Cofinity Commercial |
$21.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.92
|
| Rate for Payer: Healthscope Commercial |
$22.78
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Healthscope Commercial |
$29.80
|
| Rate for Payer: Healthscope Commercial |
$20.58
|
| Rate for Payer: Healthscope Commercial |
$22.38
|
| Rate for Payer: Healthscope Commercial |
$18.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.24
|
| Rate for Payer: PHP Commercial |
$28.60
|
| Rate for Payer: PHP Commercial |
$17.48
|
| Rate for Payer: PHP Commercial |
$19.44
|
| Rate for Payer: PHP Commercial |
$21.51
|
| Rate for Payer: PHP Commercial |
$21.14
|
| Rate for Payer: PHP Commercial |
$28.14
|
| Rate for Payer: Priority Health SBD |
$15.67
|
| Rate for Payer: Priority Health SBD |
$15.95
|
| Rate for Payer: Priority Health SBD |
$20.86
|
| Rate for Payer: Priority Health SBD |
$21.20
|
| Rate for Payer: Priority Health SBD |
$14.41
|
| Rate for Payer: Priority Health SBD |
$12.95
|
|
|
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION
|
Facility
|
IP
|
$20.65
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.01 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Commercial |
$23.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.19
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$22.38
|
| Rate for Payer: Cofinity Advantage |
$14.46
|
| Rate for Payer: Cofinity Advantage |
$19.59
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$24.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$25.18
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.98
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: PHP Commercial |
$23.78
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: Priority Health SBD |
$17.63
|
|
|
ROPIVACAINE (PF) 7.5 MG/ML (0.75 %) INJECTION SOLUTION
|
Facility
|
OP
|
$27.98
|
|
|
Service Code
|
HCPCS J2795
|
| Hospital Charge Code |
18193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$25.18 |
| Rate for Payer: Aetna Commercial |
$23.78
|
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Medicare |
$13.99
|
| Rate for Payer: Aetna Medicare |
$10.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.19
|
| Rate for Payer: BCBS Complete |
$11.19
|
| Rate for Payer: BCBS Complete |
$8.26
|
| Rate for Payer: BCBS Trust/PPO |
$0.12
|
| Rate for Payer: BCBS Trust/PPO |
$0.12
|
| Rate for Payer: BCN Commercial |
$0.12
|
| Rate for Payer: BCN Commercial |
$0.12
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cash Price |
$22.38
|
| Rate for Payer: Cash Price |
$22.38
|
| Rate for Payer: Cofinity Advantage |
$14.46
|
| Rate for Payer: Cofinity Advantage |
$19.59
|
| Rate for Payer: Cofinity Commercial |
$24.06
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Healthscope Commercial |
$25.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.98
|
| Rate for Payer: PHP Commercial |
$23.78
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: Priority Health SBD |
$13.01
|
| Rate for Payer: Priority Health SBD |
$17.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Core |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
| Rate for Payer: UHC Exchange |
$0.08
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$130.32
|
|
|
Service Code
|
NDC 50268070915
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$117.29 |
| Rate for Payer: Aetna Commercial |
$110.77
|
| Rate for Payer: Aetna Medicare |
$65.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.71
|
| Rate for Payer: BCBS Complete |
$52.13
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Cofinity Advantage |
$91.22
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$117.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.74
|
| Rate for Payer: PHP Commercial |
$110.77
|
| Rate for Payer: Priority Health SBD |
$82.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.71
|
| Rate for Payer: UHC Core |
$67.90
|
| Rate for Payer: UHC Exchange |
$51.22
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$2.61
|
|
|
Service Code
|
NDC 50268070911
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.03 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Aetna Commercial |
$2.22
|
| Rate for Payer: Aetna Medicare |
$1.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.70
|
| Rate for Payer: BCBS Complete |
$1.04
|
| Rate for Payer: Cash Price |
$2.09
|
| Rate for Payer: Cofinity Advantage |
$1.83
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.09
|
| Rate for Payer: Healthscope Commercial |
$2.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.96
|
| Rate for Payer: PHP Commercial |
$2.22
|
| Rate for Payer: Priority Health SBD |
$1.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.70
|
| Rate for Payer: UHC Core |
$1.36
|
| Rate for Payer: UHC Exchange |
$1.03
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$638.88
|
|
|
Service Code
|
NDC 60687024501
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$402.49 |
| Max. Negotiated Rate |
$574.99 |
| Rate for Payer: Aetna Commercial |
$543.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.27
|
| Rate for Payer: Cash Price |
$511.10
|
| Rate for Payer: Cofinity Advantage |
$447.22
|
| Rate for Payer: Cofinity Commercial |
$549.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.10
|
| Rate for Payer: Healthscope Commercial |
$574.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$543.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.16
|
| Rate for Payer: PHP Commercial |
$543.05
|
| Rate for Payer: Priority Health SBD |
$402.49
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$493.44
|
|
|
Service Code
|
NDC 00904677961
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$310.87 |
| Max. Negotiated Rate |
$444.10 |
| Rate for Payer: Aetna Commercial |
$419.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Cash Price |
$394.75
|
| Rate for Payer: Cofinity Advantage |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$424.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.75
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.08
|
| Rate for Payer: PHP Commercial |
$419.42
|
| Rate for Payer: Priority Health SBD |
$310.87
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$130.32
|
|
|
Service Code
|
NDC 50268070915
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.10 |
| Max. Negotiated Rate |
$117.29 |
| Rate for Payer: Aetna Commercial |
$110.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.71
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Cofinity Advantage |
$91.22
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$117.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.74
|
| Rate for Payer: PHP Commercial |
$110.77
|
| Rate for Payer: Priority Health SBD |
$82.10
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$493.44
|
|
|
Service Code
|
NDC 00904677961
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$193.92 |
| Max. Negotiated Rate |
$444.10 |
| Rate for Payer: Aetna Commercial |
$419.42
|
| Rate for Payer: Aetna Medicare |
$246.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: BCBS Complete |
$197.38
|
| Rate for Payer: Cash Price |
$394.75
|
| Rate for Payer: Cofinity Advantage |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$424.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.75
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$394.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.08
|
| Rate for Payer: PHP Commercial |
$419.42
|
| Rate for Payer: Priority Health SBD |
$310.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$320.74
|
| Rate for Payer: UHC Core |
$257.08
|
| Rate for Payer: UHC Exchange |
$193.92
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$6.39
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.15
|
| Rate for Payer: BCBS Complete |
$2.56
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cofinity Advantage |
$4.47
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.11
|
| Rate for Payer: Healthscope Commercial |
$5.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.79
|
| Rate for Payer: PHP Commercial |
$5.43
|
| Rate for Payer: Priority Health SBD |
$4.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.15
|
| Rate for Payer: UHC Core |
$3.33
|
| Rate for Payer: UHC Exchange |
$2.51
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$2.61
|
|
|
Service Code
|
NDC 50268070911
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.64 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Aetna Commercial |
$2.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.70
|
| Rate for Payer: Cash Price |
$2.09
|
| Rate for Payer: Cofinity Advantage |
$1.83
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.09
|
| Rate for Payer: Healthscope Commercial |
$2.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.96
|
| Rate for Payer: PHP Commercial |
$2.22
|
| Rate for Payer: Priority Health SBD |
$1.64
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$6.39
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.15
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cofinity Advantage |
$4.47
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.11
|
| Rate for Payer: Healthscope Commercial |
$5.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.79
|
| Rate for Payer: PHP Commercial |
$5.43
|
| Rate for Payer: Priority Health SBD |
$4.03
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$638.88
|
|
|
Service Code
|
NDC 60687024501
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$251.08 |
| Max. Negotiated Rate |
$574.99 |
| Rate for Payer: Aetna Commercial |
$543.05
|
| Rate for Payer: Aetna Medicare |
$319.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.27
|
| Rate for Payer: BCBS Complete |
$255.55
|
| Rate for Payer: Cash Price |
$511.10
|
| Rate for Payer: Cofinity Advantage |
$447.22
|
| Rate for Payer: Cofinity Commercial |
$549.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$511.10
|
| Rate for Payer: Healthscope Commercial |
$574.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$543.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$479.16
|
| Rate for Payer: PHP Commercial |
$543.05
|
| Rate for Payer: Priority Health SBD |
$402.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$415.27
|
| Rate for Payer: UHC Core |
$332.86
|
| Rate for Payer: UHC Exchange |
$251.08
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$182.88
|
|
|
Service Code
|
NDC 50268071115
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.87 |
| Max. Negotiated Rate |
$164.59 |
| Rate for Payer: Aetna Commercial |
$155.45
|
| Rate for Payer: Aetna Medicare |
$91.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.87
|
| Rate for Payer: BCBS Complete |
$73.15
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: Cofinity Advantage |
$128.02
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.30
|
| Rate for Payer: Healthscope Commercial |
$164.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.16
|
| Rate for Payer: PHP Commercial |
$155.45
|
| Rate for Payer: Priority Health SBD |
$115.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.87
|
| Rate for Payer: UHC Core |
$95.28
|
| Rate for Payer: UHC Exchange |
$71.87
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.66
|
|
|
Service Code
|
NDC 50268071111
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$3.29 |
| Rate for Payer: Aetna Commercial |
$3.11
|
| Rate for Payer: Aetna Medicare |
$1.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.38
|
| Rate for Payer: BCBS Complete |
$1.46
|
| Rate for Payer: Cash Price |
$2.93
|
| Rate for Payer: Cofinity Advantage |
$2.56
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.93
|
| Rate for Payer: Healthscope Commercial |
$3.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.75
|
| Rate for Payer: PHP Commercial |
$3.11
|
| Rate for Payer: Priority Health SBD |
$2.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.38
|
| Rate for Payer: UHC Core |
$1.91
|
| Rate for Payer: UHC Exchange |
$1.44
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$182.88
|
|
|
Service Code
|
NDC 50268071115
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.21 |
| Max. Negotiated Rate |
$164.59 |
| Rate for Payer: Aetna Commercial |
$155.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.87
|
| Rate for Payer: Cash Price |
$146.30
|
| Rate for Payer: Cofinity Advantage |
$128.02
|
| Rate for Payer: Cofinity Commercial |
$157.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.30
|
| Rate for Payer: Healthscope Commercial |
$164.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$155.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$137.16
|
| Rate for Payer: PHP Commercial |
$155.45
|
| Rate for Payer: Priority Health SBD |
$115.21
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.66
|
|
|
Service Code
|
NDC 50268071111
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$3.29 |
| Rate for Payer: Aetna Commercial |
$3.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.38
|
| Rate for Payer: Cash Price |
$2.93
|
| Rate for Payer: Cofinity Advantage |
$2.56
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.93
|
| Rate for Payer: Healthscope Commercial |
$3.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.75
|
| Rate for Payer: PHP Commercial |
$3.11
|
| Rate for Payer: Priority Health SBD |
$2.31
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
OP
|
$217.85
|
|
|
Service Code
|
NDC 67877043990
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$85.62 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna Medicare |
$108.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: BCBS Complete |
$87.14
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.60
|
| Rate for Payer: UHC Core |
$113.50
|
| Rate for Payer: UHC Exchange |
$85.62
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
IP
|
$217.85
|
|
|
Service Code
|
NDC 67877043990
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.25 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
OP
|
$222.30
|
|
|
Service Code
|
NDC 00781540092
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$87.36 |
| Max. Negotiated Rate |
$200.07 |
| Rate for Payer: Aetna Commercial |
$188.96
|
| Rate for Payer: Aetna Medicare |
$111.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.50
|
| Rate for Payer: BCBS Complete |
$88.92
|
| Rate for Payer: Cash Price |
$177.84
|
| Rate for Payer: Cofinity Advantage |
$155.61
|
| Rate for Payer: Cofinity Commercial |
$191.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$177.84
|
| Rate for Payer: Healthscope Commercial |
$200.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$188.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.72
|
| Rate for Payer: PHP Commercial |
$188.96
|
| Rate for Payer: Priority Health SBD |
$140.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.50
|
| Rate for Payer: UHC Core |
$115.82
|
| Rate for Payer: UHC Exchange |
$87.36
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
OP
|
$133.25
|
|
|
Service Code
|
NDC 65862029390
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.37 |
| Max. Negotiated Rate |
$119.92 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Medicare |
$66.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.61
|
| Rate for Payer: BCBS Complete |
$53.30
|
| Rate for Payer: Cash Price |
$106.60
|
| Rate for Payer: Cofinity Advantage |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$114.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.60
|
| Rate for Payer: Healthscope Commercial |
$119.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.94
|
| Rate for Payer: PHP Commercial |
$113.26
|
| Rate for Payer: Priority Health SBD |
$83.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.61
|
| Rate for Payer: UHC Core |
$69.42
|
| Rate for Payer: UHC Exchange |
$52.37
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
OP
|
$395.04
|
|
|
Service Code
|
NDC 00904677861
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$155.25 |
| Max. Negotiated Rate |
$355.54 |
| Rate for Payer: Aetna Commercial |
$335.78
|
| Rate for Payer: Aetna Medicare |
$197.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.78
|
| Rate for Payer: BCBS Complete |
$158.02
|
| Rate for Payer: Cash Price |
$316.03
|
| Rate for Payer: Cofinity Advantage |
$276.53
|
| Rate for Payer: Cofinity Commercial |
$339.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.03
|
| Rate for Payer: Healthscope Commercial |
$355.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$316.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.28
|
| Rate for Payer: PHP Commercial |
$335.78
|
| Rate for Payer: Priority Health SBD |
$248.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.78
|
| Rate for Payer: UHC Core |
$205.82
|
| Rate for Payer: UHC Exchange |
$155.25
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
IP
|
$133.25
|
|
|
Service Code
|
NDC 65862029390
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.95 |
| Max. Negotiated Rate |
$119.92 |
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.61
|
| Rate for Payer: Cash Price |
$106.60
|
| Rate for Payer: Cofinity Advantage |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$114.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.60
|
| Rate for Payer: Healthscope Commercial |
$119.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.94
|
| Rate for Payer: PHP Commercial |
$113.26
|
| Rate for Payer: Priority Health SBD |
$83.95
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
IP
|
$395.04
|
|
|
Service Code
|
NDC 00904677861
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$248.88 |
| Max. Negotiated Rate |
$355.54 |
| Rate for Payer: Aetna Commercial |
$335.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.78
|
| Rate for Payer: Cash Price |
$316.03
|
| Rate for Payer: Cofinity Advantage |
$276.53
|
| Rate for Payer: Cofinity Commercial |
$339.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.03
|
| Rate for Payer: Healthscope Commercial |
$355.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$335.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.28
|
| Rate for Payer: PHP Commercial |
$335.78
|
| Rate for Payer: Priority Health SBD |
$248.88
|
|
|
ROSUVASTATIN 5 MG TABLET
|
Facility
|
IP
|
$93.06
|
|
|
Service Code
|
NDC 68462026190
|
| Hospital Charge Code |
36612
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.63 |
| Max. Negotiated Rate |
$83.75 |
| Rate for Payer: Healthscope Commercial |
$83.75
|
| Rate for Payer: Aetna Commercial |
$79.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.49
|
| Rate for Payer: Cash Price |
$74.45
|
| Rate for Payer: Cofinity Advantage |
$65.14
|
| Rate for Payer: Cofinity Commercial |
$80.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.80
|
| Rate for Payer: PHP Commercial |
$79.10
|
| Rate for Payer: Priority Health SBD |
$58.63
|
|
