|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$2.16
|
|
|
Service Code
|
NDC 68084009711
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna Medicare |
$1.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.40
|
| Rate for Payer: BCBS Complete |
$0.86
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cofinity Advantage |
$1.51
|
| Rate for Payer: Cofinity Commercial |
$1.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.73
|
| Rate for Payer: Healthscope Commercial |
$1.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: Priority Health SBD |
$1.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.40
|
| Rate for Payer: UHC Core |
$1.13
|
| Rate for Payer: UHC Exchange |
$0.85
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$1.92
|
|
|
Service Code
|
NDC 50268009311
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.75 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: Aetna Medicare |
$0.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.25
|
| Rate for Payer: BCBS Complete |
$0.77
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Advantage |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: Priority Health SBD |
$1.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.25
|
| Rate for Payer: UHC Core |
$1.00
|
| Rate for Payer: UHC Exchange |
$0.75
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$215.65
|
|
|
Service Code
|
NDC 68084009701
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.86 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.17
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Advantage |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health SBD |
$135.86
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$195.70
|
|
|
Service Code
|
NDC 00904629061
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$123.29 |
| Max. Negotiated Rate |
$176.13 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.20
|
| Rate for Payer: Cash Price |
$156.56
|
| Rate for Payer: Cofinity Advantage |
$136.99
|
| Rate for Payer: Cofinity Commercial |
$168.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.56
|
| Rate for Payer: Healthscope Commercial |
$176.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.78
|
| Rate for Payer: PHP Commercial |
$166.34
|
| Rate for Payer: Priority Health SBD |
$123.29
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$215.65
|
|
|
Service Code
|
NDC 51079020820
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.86 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.17
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Advantage |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health SBD |
$135.86
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$195.70
|
|
|
Service Code
|
NDC 00904629061
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$76.91 |
| Max. Negotiated Rate |
$176.13 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna Medicare |
$97.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.20
|
| Rate for Payer: BCBS Complete |
$78.28
|
| Rate for Payer: Cash Price |
$156.56
|
| Rate for Payer: Cofinity Advantage |
$136.99
|
| Rate for Payer: Cofinity Commercial |
$168.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.56
|
| Rate for Payer: Healthscope Commercial |
$176.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.78
|
| Rate for Payer: PHP Commercial |
$166.34
|
| Rate for Payer: Priority Health SBD |
$123.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.20
|
| Rate for Payer: UHC Core |
$101.96
|
| Rate for Payer: UHC Exchange |
$76.91
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$2.16
|
|
|
Service Code
|
NDC 51079020801
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.40
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cofinity Advantage |
$1.51
|
| Rate for Payer: Cofinity Commercial |
$1.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.73
|
| Rate for Payer: Healthscope Commercial |
$1.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: Priority Health SBD |
$1.36
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$1.92
|
|
|
Service Code
|
NDC 50268009311
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$1.73 |
| Rate for Payer: Aetna Commercial |
$1.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.25
|
| Rate for Payer: Cash Price |
$1.54
|
| Rate for Payer: Cofinity Advantage |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.54
|
| Rate for Payer: Healthscope Commercial |
$1.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.44
|
| Rate for Payer: PHP Commercial |
$1.63
|
| Rate for Payer: Priority Health SBD |
$1.21
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$215.03
|
|
|
Service Code
|
NDC 00904629006
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.51 |
| Max. Negotiated Rate |
$193.53 |
| Rate for Payer: Aetna Commercial |
$182.78
|
| Rate for Payer: Aetna Medicare |
$107.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.77
|
| Rate for Payer: BCBS Complete |
$86.01
|
| Rate for Payer: Cash Price |
$172.02
|
| Rate for Payer: Cofinity Advantage |
$150.52
|
| Rate for Payer: Cofinity Commercial |
$184.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.02
|
| Rate for Payer: Healthscope Commercial |
$193.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.27
|
| Rate for Payer: PHP Commercial |
$182.78
|
| Rate for Payer: Priority Health SBD |
$135.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.77
|
| Rate for Payer: UHC Core |
$112.03
|
| Rate for Payer: UHC Exchange |
$84.51
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$95.95
|
|
|
Service Code
|
NDC 50268009315
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.71 |
| Max. Negotiated Rate |
$86.36 |
| Rate for Payer: Aetna Commercial |
$81.56
|
| Rate for Payer: Aetna Medicare |
$47.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.37
|
| Rate for Payer: BCBS Complete |
$38.38
|
| Rate for Payer: Cash Price |
$76.76
|
| Rate for Payer: Cofinity Advantage |
$67.17
|
| Rate for Payer: Cofinity Commercial |
$82.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.76
|
| Rate for Payer: Healthscope Commercial |
$86.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.96
|
| Rate for Payer: PHP Commercial |
$81.56
|
| Rate for Payer: Priority Health SBD |
$60.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.37
|
| Rate for Payer: UHC Core |
$49.99
|
| Rate for Payer: UHC Exchange |
$37.71
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$215.65
|
|
|
Service Code
|
NDC 51079020820
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.75 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna Medicare |
$107.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.17
|
| Rate for Payer: BCBS Complete |
$86.26
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Advantage |
$150.96
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Healthscope Commercial |
$194.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health SBD |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.17
|
| Rate for Payer: UHC Core |
$112.35
|
| Rate for Payer: UHC Exchange |
$84.75
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$247.95
|
|
|
Service Code
|
NDC 68084009801
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.21 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.17
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Advantage |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$213.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$223.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health SBD |
$156.21
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$225.15
|
|
|
Service Code
|
NDC 00904629161
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.48 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna Medicare |
$112.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: BCBS Complete |
$90.06
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.35
|
| Rate for Payer: UHC Core |
$117.30
|
| Rate for Payer: UHC Exchange |
$88.48
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$247.95
|
|
|
Service Code
|
NDC 68084009801
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.44 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna Medicare |
$123.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.17
|
| Rate for Payer: BCBS Complete |
$99.18
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Advantage |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$213.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$223.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health SBD |
$156.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.17
|
| Rate for Payer: UHC Core |
$129.18
|
| Rate for Payer: UHC Exchange |
$97.44
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 00904629161
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$141.84 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$2.48
|
|
|
Service Code
|
NDC 68084009811
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.61
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health SBD |
$1.56
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$247.95
|
|
|
Service Code
|
NDC 51079020920
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.44 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna Medicare |
$123.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.17
|
| Rate for Payer: BCBS Complete |
$99.18
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Advantage |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$213.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$223.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health SBD |
$156.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.17
|
| Rate for Payer: UHC Core |
$129.18
|
| Rate for Payer: UHC Exchange |
$97.44
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$2.48
|
|
|
Service Code
|
NDC 68084009811
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna Medicare |
$1.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.61
|
| Rate for Payer: BCBS Complete |
$0.99
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Advantage |
$1.74
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health SBD |
$1.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.61
|
| Rate for Payer: UHC Core |
$1.29
|
| Rate for Payer: UHC Exchange |
$0.97
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$247.95
|
|
|
Service Code
|
NDC 51079020920
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.21 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.17
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Advantage |
$173.56
|
| Rate for Payer: Cofinity Commercial |
$213.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$223.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health SBD |
$156.21
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$95.95
|
|
|
Service Code
|
NDC 00904629206
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.71 |
| Max. Negotiated Rate |
$86.36 |
| Rate for Payer: Aetna Commercial |
$81.56
|
| Rate for Payer: Aetna Medicare |
$47.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.37
|
| Rate for Payer: BCBS Complete |
$38.38
|
| Rate for Payer: Cash Price |
$76.76
|
| Rate for Payer: Cofinity Advantage |
$67.17
|
| Rate for Payer: Cofinity Commercial |
$82.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.76
|
| Rate for Payer: Healthscope Commercial |
$86.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.96
|
| Rate for Payer: PHP Commercial |
$81.56
|
| Rate for Payer: Priority Health SBD |
$60.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.37
|
| Rate for Payer: UHC Core |
$49.99
|
| Rate for Payer: UHC Exchange |
$37.71
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$304.56
|
|
|
Service Code
|
NDC 00378395277
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.87 |
| Max. Negotiated Rate |
$274.10 |
| Rate for Payer: Aetna Commercial |
$258.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.96
|
| Rate for Payer: Cash Price |
$243.65
|
| Rate for Payer: Cofinity Advantage |
$213.19
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.65
|
| Rate for Payer: Healthscope Commercial |
$274.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.42
|
| Rate for Payer: PHP Commercial |
$258.88
|
| Rate for Payer: Priority Health SBD |
$191.87
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$3.47 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.51
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$2.70
|
| Rate for Payer: Cofinity Commercial |
$3.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.28
|
| Rate for Payer: Priority Health SBD |
$2.43
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$304.56
|
|
|
Service Code
|
NDC 00378395277
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$119.69 |
| Max. Negotiated Rate |
$274.10 |
| Rate for Payer: Aetna Commercial |
$258.88
|
| Rate for Payer: Aetna Medicare |
$152.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.96
|
| Rate for Payer: BCBS Complete |
$121.82
|
| Rate for Payer: Cash Price |
$243.65
|
| Rate for Payer: Cofinity Advantage |
$213.19
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.65
|
| Rate for Payer: Healthscope Commercial |
$274.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.42
|
| Rate for Payer: PHP Commercial |
$258.88
|
| Rate for Payer: Priority Health SBD |
$191.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.96
|
| Rate for Payer: UHC Core |
$158.68
|
| Rate for Payer: UHC Exchange |
$119.69
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.52 |
| Max. Negotiated Rate |
$3.47 |
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare |
$1.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.51
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$2.70
|
| Rate for Payer: Cofinity Commercial |
$3.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.28
|
| Rate for Payer: Priority Health SBD |
$2.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.51
|
| Rate for Payer: UHC Core |
$2.01
|
| Rate for Payer: UHC Exchange |
$1.52
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$2.11
|
|
|
Service Code
|
NDC 50268009511
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$1.90 |
| Rate for Payer: Aetna Commercial |
$1.79
|
| Rate for Payer: Aetna Medicare |
$1.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.37
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: Cash Price |
$1.69
|
| Rate for Payer: Cofinity Advantage |
$1.48
|
| Rate for Payer: Cofinity Commercial |
$1.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.69
|
| Rate for Payer: Healthscope Commercial |
$1.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.58
|
| Rate for Payer: PHP Commercial |
$1.79
|
| Rate for Payer: Priority Health SBD |
$1.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.37
|
| Rate for Payer: UHC Core |
$1.10
|
| Rate for Payer: UHC Exchange |
$0.83
|
|
