Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ATORVASTATIN 40 MG TABLET

Facility

$248.90

Service Code	NDC 68084009901
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$97.82
Max. Negotiated Rate	$224.01
Rate for Payer: Aetna Commercial	$211.56
Rate for Payer: Aetna Medicare	$124.45
Rate for Payer: Aetna New Business (MI Preferred)	$161.78
Rate for Payer: BCBS Complete	$99.56
Rate for Payer: Cash Price	$199.12
Rate for Payer: Cofinity Advantage	$174.23
Rate for Payer: Cofinity Commercial	$214.05
Rate for Payer: Encore Health Key Benefits Commercial	$199.12
Rate for Payer: Healthscope Commercial	$224.01
Rate for Payer: MI Amish Medical Board Commercial	$199.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$186.68
Rate for Payer: PHP Commercial	$211.56
Rate for Payer: Priority Health SBD	$156.81
Rate for Payer: UHC All Payor (Choice/PPO)	$161.78
Rate for Payer: UHC Core	$129.68
Rate for Payer: UHC Exchange	$97.82

ATORVASTATIN 40 MG TABLET

Facility

$385.70

Service Code	NDC 51079021020
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$151.58
Max. Negotiated Rate	$347.13
Rate for Payer: Aetna Commercial	$327.85
Rate for Payer: Aetna Medicare	$192.85
Rate for Payer: Aetna New Business (MI Preferred)	$250.71
Rate for Payer: BCBS Complete	$154.28
Rate for Payer: Cash Price	$308.56
Rate for Payer: Cofinity Advantage	$269.99
Rate for Payer: Cofinity Commercial	$331.70
Rate for Payer: Encore Health Key Benefits Commercial	$308.56
Rate for Payer: Healthscope Commercial	$347.13
Rate for Payer: MI Amish Medical Board Commercial	$308.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$327.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$289.27
Rate for Payer: PHP Commercial	$327.85
Rate for Payer: Priority Health SBD	$242.99
Rate for Payer: UHC All Payor (Choice/PPO)	$250.71
Rate for Payer: UHC Core	$200.95
Rate for Payer: UHC Exchange	$151.58

ATORVASTATIN 40 MG TABLET

Facility

$226.10

Service Code	NDC 00904629261
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$142.44
Max. Negotiated Rate	$203.49
Rate for Payer: Aetna Commercial	$192.19
Rate for Payer: Aetna New Business (MI Preferred)	$146.97
Rate for Payer: Cash Price	$180.88
Rate for Payer: Cofinity Advantage	$158.27
Rate for Payer: Cofinity Commercial	$194.45
Rate for Payer: Encore Health Key Benefits Commercial	$180.88
Rate for Payer: Healthscope Commercial	$203.49
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$192.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$169.57
Rate for Payer: PHP Commercial	$192.19
Rate for Payer: Priority Health SBD	$142.44

ATORVASTATIN 40 MG TABLET

Facility

$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

$105.45

Service Code	NDC 50268009515
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$41.44
Max. Negotiated Rate	$94.91
Rate for Payer: Aetna Commercial	$89.63
Rate for Payer: Aetna Medicare	$52.73
Rate for Payer: Aetna New Business (MI Preferred)	$68.54
Rate for Payer: BCBS Complete	$42.18
Rate for Payer: Cash Price	$84.36
Rate for Payer: Cofinity Advantage	$73.81
Rate for Payer: Cofinity Commercial	$90.69
Rate for Payer: Encore Health Key Benefits Commercial	$84.36
Rate for Payer: Healthscope Commercial	$94.91
Rate for Payer: MI Amish Medical Board Commercial	$84.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$79.09
Rate for Payer: PHP Commercial	$89.63
Rate for Payer: Priority Health SBD	$66.43
Rate for Payer: UHC All Payor (Choice/PPO)	$68.54
Rate for Payer: UHC Core	$54.94
Rate for Payer: UHC Exchange	$41.44

ATORVASTATIN 40 MG TABLET

Facility

$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

ATORVASTATIN 40 MG TABLET

Facility

$105.45

Service Code	NDC 50268009515
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$66.43
Max. Negotiated Rate	$94.91
Rate for Payer: Aetna Commercial	$89.63
Rate for Payer: Aetna New Business (MI Preferred)	$68.54
Rate for Payer: Cash Price	$84.36
Rate for Payer: Cofinity Advantage	$73.81
Rate for Payer: Cofinity Commercial	$90.69
Rate for Payer: Encore Health Key Benefits Commercial	$84.36
Rate for Payer: Healthscope Commercial	$94.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$89.63
Rate for Payer: Opus (Opus Packaging Group) HMA	$79.09
Rate for Payer: PHP Commercial	$89.63
Rate for Payer: Priority Health SBD	$66.43

ATORVASTATIN 40 MG TABLET

Facility

$385.70

Service Code	NDC 51079021020
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$242.99
Max. Negotiated Rate	$347.13
Rate for Payer: Aetna Commercial	$327.85
Rate for Payer: Aetna New Business (MI Preferred)	$250.71
Rate for Payer: Cash Price	$308.56
Rate for Payer: Cofinity Advantage	$269.99
Rate for Payer: Cofinity Commercial	$331.70
Rate for Payer: Encore Health Key Benefits Commercial	$308.56
Rate for Payer: Healthscope Commercial	$347.13
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$327.85
Rate for Payer: Opus (Opus Packaging Group) HMA	$289.27
Rate for Payer: PHP Commercial	$327.85
Rate for Payer: Priority Health SBD	$242.99

ATORVASTATIN 40 MG TABLET

Facility

$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

$248.90

Service Code	NDC 68084009901
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$156.81
Max. Negotiated Rate	$224.01
Rate for Payer: Aetna Commercial	$211.56
Rate for Payer: Aetna New Business (MI Preferred)	$161.78
Rate for Payer: Cash Price	$199.12
Rate for Payer: Cofinity Advantage	$174.23
Rate for Payer: Cofinity Commercial	$214.05
Rate for Payer: Encore Health Key Benefits Commercial	$199.12
Rate for Payer: Healthscope Commercial	$224.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$211.56
Rate for Payer: Opus (Opus Packaging Group) HMA	$186.68
Rate for Payer: PHP Commercial	$211.56
Rate for Payer: Priority Health SBD	$156.81

ATORVASTATIN 40 MG TABLET

Facility

$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

$95.95

Service Code	NDC 00904629206
Hospital Charge Code	19177
Hospital Revenue Code	637
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$86.36
Rate for Payer: Aetna Commercial	$81.56
Rate for Payer: Aetna New Business (MI Preferred)	$62.37
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: 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

ATORVASTATIN 80 MG TABLET

Facility

$133.67

Service Code	NDC 00904629304
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$84.21
Max. Negotiated Rate	$120.30
Rate for Payer: Aetna Commercial	$113.62
Rate for Payer: Aetna New Business (MI Preferred)	$86.89
Rate for Payer: Cash Price	$106.94
Rate for Payer: Cofinity Advantage	$93.57
Rate for Payer: Cofinity Commercial	$114.96
Rate for Payer: Encore Health Key Benefits Commercial	$106.94
Rate for Payer: Healthscope Commercial	$120.30
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$113.62
Rate for Payer: Opus (Opus Packaging Group) HMA	$100.25
Rate for Payer: PHP Commercial	$113.62
Rate for Payer: Priority Health SBD	$84.21

ATORVASTATIN 80 MG TABLET

Facility

$196.70

Service Code	NDC 69097094705
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$77.30
Max. Negotiated Rate	$177.03
Rate for Payer: Aetna Commercial	$167.19
Rate for Payer: Aetna Medicare	$98.35
Rate for Payer: Aetna New Business (MI Preferred)	$127.86
Rate for Payer: BCBS Complete	$78.68
Rate for Payer: Cash Price	$157.36
Rate for Payer: Cofinity Advantage	$137.69
Rate for Payer: Cofinity Commercial	$169.16
Rate for Payer: Encore Health Key Benefits Commercial	$157.36
Rate for Payer: Healthscope Commercial	$177.03
Rate for Payer: MI Amish Medical Board Commercial	$157.36
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$167.19
Rate for Payer: Opus (Opus Packaging Group) HMA	$147.53
Rate for Payer: PHP Commercial	$167.19
Rate for Payer: Priority Health SBD	$123.92
Rate for Payer: UHC All Payor (Choice/PPO)	$127.86
Rate for Payer: UHC Core	$102.48
Rate for Payer: UHC Exchange	$77.30

ATORVASTATIN 80 MG TABLET

Facility

$2.48

Service Code	NDC 51079021101
Hospital Charge Code	28645
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 80 MG TABLET

Facility

$304.56

Service Code	NDC 00378395377
Hospital Charge Code	28645
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 80 MG TABLET

Facility

$5,723.61

Service Code	NDC 00071015823
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$2,249.38
Max. Negotiated Rate	$5,151.25
Rate for Payer: Aetna Commercial	$4,865.07
Rate for Payer: Aetna Medicare	$2,861.80
Rate for Payer: Aetna New Business (MI Preferred)	$3,720.35
Rate for Payer: BCBS Complete	$2,289.44
Rate for Payer: Cash Price	$4,578.89
Rate for Payer: Cofinity Advantage	$4,006.53
Rate for Payer: Cofinity Commercial	$4,922.30
Rate for Payer: Encore Health Key Benefits Commercial	$4,578.89
Rate for Payer: Healthscope Commercial	$5,151.25
Rate for Payer: MI Amish Medical Board Commercial	$4,578.89
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,865.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,292.71
Rate for Payer: PHP Commercial	$4,865.07
Rate for Payer: Priority Health SBD	$3,605.87
Rate for Payer: UHC All Payor (Choice/PPO)	$3,720.35
Rate for Payer: UHC Core	$2,982.00
Rate for Payer: UHC Exchange	$2,249.38

ATORVASTATIN 80 MG TABLET

Facility

$74.45

Service Code	NDC 68084059025
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$46.90
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$63.28
Rate for Payer: Aetna New Business (MI Preferred)	$48.39
Rate for Payer: Cash Price	$59.56
Rate for Payer: Cofinity Advantage	$52.12
Rate for Payer: Cofinity Commercial	$64.03
Rate for Payer: Encore Health Key Benefits Commercial	$59.56
Rate for Payer: Healthscope Commercial	$67.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$55.84
Rate for Payer: PHP Commercial	$63.28
Rate for Payer: Priority Health SBD	$46.90

ATORVASTATIN 80 MG TABLET

Facility

$74.45

Service Code	NDC 68084059025
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$29.26
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$63.28
Rate for Payer: Aetna Medicare	$37.23
Rate for Payer: Aetna New Business (MI Preferred)	$48.39
Rate for Payer: BCBS Complete	$29.78
Rate for Payer: Cash Price	$59.56
Rate for Payer: Cofinity Advantage	$52.12
Rate for Payer: Cofinity Commercial	$64.03
Rate for Payer: Encore Health Key Benefits Commercial	$59.56
Rate for Payer: Healthscope Commercial	$67.00
Rate for Payer: MI Amish Medical Board Commercial	$59.56
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.28
Rate for Payer: Opus (Opus Packaging Group) HMA	$55.84
Rate for Payer: PHP Commercial	$63.28
Rate for Payer: Priority Health SBD	$46.90
Rate for Payer: UHC All Payor (Choice/PPO)	$48.39
Rate for Payer: UHC Core	$38.79
Rate for Payer: UHC Exchange	$29.26

ATORVASTATIN 80 MG TABLET

Facility

$304.56

Service Code	NDC 00378395377
Hospital Charge Code	28645
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 80 MG TABLET

Facility

$74.31

Service Code	NDC 51079021103
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$46.82
Max. Negotiated Rate	$66.88
Rate for Payer: Aetna Commercial	$63.16
Rate for Payer: Aetna New Business (MI Preferred)	$48.30
Rate for Payer: Cash Price	$59.45
Rate for Payer: Cofinity Advantage	$52.02
Rate for Payer: Cofinity Commercial	$63.91
Rate for Payer: Encore Health Key Benefits Commercial	$59.45
Rate for Payer: Healthscope Commercial	$66.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.16
Rate for Payer: Opus (Opus Packaging Group) HMA	$55.73
Rate for Payer: PHP Commercial	$63.16
Rate for Payer: Priority Health SBD	$46.82

ATORVASTATIN 80 MG TABLET

Facility

$2.48

Service Code	NDC 51079021101
Hospital Charge Code	28645
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 80 MG TABLET

Facility

$357.44

Service Code	NDC 67877051490
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$225.19
Max. Negotiated Rate	$321.70
Rate for Payer: Aetna Commercial	$303.82
Rate for Payer: Aetna New Business (MI Preferred)	$232.34
Rate for Payer: Cash Price	$285.95
Rate for Payer: Cofinity Advantage	$250.21
Rate for Payer: Cofinity Commercial	$307.40
Rate for Payer: Encore Health Key Benefits Commercial	$285.95
Rate for Payer: Healthscope Commercial	$321.70
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$303.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$268.08
Rate for Payer: PHP Commercial	$303.82
Rate for Payer: Priority Health SBD	$225.19

ATORVASTATIN 80 MG TABLET

Facility

$357.44

Service Code	NDC 67877051490
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$140.47
Max. Negotiated Rate	$321.70
Rate for Payer: Aetna Commercial	$303.82
Rate for Payer: Aetna Medicare	$178.72
Rate for Payer: Aetna New Business (MI Preferred)	$232.34
Rate for Payer: BCBS Complete	$142.98
Rate for Payer: Cash Price	$285.95
Rate for Payer: Cofinity Advantage	$250.21
Rate for Payer: Cofinity Commercial	$307.40
Rate for Payer: Encore Health Key Benefits Commercial	$285.95
Rate for Payer: Healthscope Commercial	$321.70
Rate for Payer: MI Amish Medical Board Commercial	$285.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$303.82
Rate for Payer: Opus (Opus Packaging Group) HMA	$268.08
Rate for Payer: PHP Commercial	$303.82
Rate for Payer: Priority Health SBD	$225.19
Rate for Payer: UHC All Payor (Choice/PPO)	$232.34
Rate for Payer: UHC Core	$186.23
Rate for Payer: UHC Exchange	$140.47

ATORVASTATIN 80 MG TABLET

Facility

$5,723.61

Service Code	NDC 00071015823
Hospital Charge Code	28645
Hospital Revenue Code	637
Min. Negotiated Rate	$3,605.87
Max. Negotiated Rate	$5,151.25
Rate for Payer: Aetna Commercial	$4,865.07
Rate for Payer: Aetna New Business (MI Preferred)	$3,720.35
Rate for Payer: Cash Price	$4,578.89
Rate for Payer: Cofinity Advantage	$4,006.53
Rate for Payer: Cofinity Commercial	$4,922.30
Rate for Payer: Encore Health Key Benefits Commercial	$4,578.89
Rate for Payer: Healthscope Commercial	$5,151.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4,865.07
Rate for Payer: Opus (Opus Packaging Group) HMA	$4,292.71
Rate for Payer: PHP Commercial	$4,865.07
Rate for Payer: Priority Health SBD	$3,605.87

Know your out-of-pocket cost for care.

All Charges