Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

ATENOLOL 25 MG TABLET

Facility

$430.05

Service Code	NDC 51079075920
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$172.02
Max. Negotiated Rate	$387.05
Rate for Payer: Aetna Commercial	$365.54
Rate for Payer: Aetna Medicare	$215.03
Rate for Payer: Aetna New Business (MI Preferred)	$279.53
Rate for Payer: BCBS Complete	$172.02
Rate for Payer: Cash Price	$344.04
Rate for Payer: Cofinity Commercial	$301.04
Rate for Payer: Cofinity Commercial	$369.84
Rate for Payer: Cofinity Medicare Advantage	$301.04
Rate for Payer: Encore Health Key Benefits Commercial	$344.04
Rate for Payer: Healthscope Commercial	$387.05
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$365.54
Rate for Payer: PHP Commercial	$365.54
Rate for Payer: Priority Health Cigna Priority Health	$279.53
Rate for Payer: Priority Health SBD	$270.93

ATENOLOL 25 MG TABLET

Facility

$4.31

Service Code	NDC 51079075901
Hospital Charge Code	717
Hospital Revenue Code	637
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$3.88
Rate for Payer: Aetna Commercial	$3.66
Rate for Payer: Aetna Medicare	$2.15
Rate for Payer: Aetna New Business (MI Preferred)	$2.80
Rate for Payer: BCBS Complete	$1.72
Rate for Payer: Cash Price	$3.45
Rate for Payer: Cofinity Commercial	$3.02
Rate for Payer: Cofinity Commercial	$3.71
Rate for Payer: Cofinity Medicare Advantage	$3.02
Rate for Payer: Encore Health Key Benefits Commercial	$3.45
Rate for Payer: Healthscope Commercial	$3.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.66
Rate for Payer: PHP Commercial	$3.66
Rate for Payer: Priority Health Cigna Priority Health	$2.80
Rate for Payer: Priority Health SBD	$2.72

ATENOLOL 50 MG TABLET

Facility

$68.15

Service Code	NDC 65862016901
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$42.93
Max. Negotiated Rate	$61.34
Rate for Payer: Aetna Commercial	$57.93
Rate for Payer: Aetna New Business (MI Preferred)	$44.30
Rate for Payer: Cash Price	$54.52
Rate for Payer: Cofinity Commercial	$47.70
Rate for Payer: Cofinity Commercial	$58.61
Rate for Payer: Cofinity Medicare Advantage	$47.70
Rate for Payer: Encore Health Key Benefits Commercial	$54.52
Rate for Payer: Healthscope Commercial	$61.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.93
Rate for Payer: PHP Commercial	$57.93
Rate for Payer: Priority Health Cigna Priority Health	$44.30
Rate for Payer: Priority Health SBD	$42.93

ATENOLOL 50 MG TABLET

Facility

$155.10

Service Code	NDC 00378023101
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$62.04
Max. Negotiated Rate	$139.59
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna Medicare	$77.55
Rate for Payer: Aetna New Business (MI Preferred)	$100.81
Rate for Payer: BCBS Complete	$62.04
Rate for Payer: Cash Price	$124.08
Rate for Payer: Cofinity Commercial	$108.57
Rate for Payer: Cofinity Commercial	$133.39
Rate for Payer: Cofinity Medicare Advantage	$108.57
Rate for Payer: Encore Health Key Benefits Commercial	$124.08
Rate for Payer: Healthscope Commercial	$139.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$131.84
Rate for Payer: PHP Commercial	$131.84
Rate for Payer: Priority Health Cigna Priority Health	$100.81
Rate for Payer: Priority Health SBD	$97.71

ATENOLOL 50 MG TABLET

Facility

$2.12

Service Code	NDC 51079068401
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$1.91
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna Medicare	$1.06
Rate for Payer: Aetna New Business (MI Preferred)	$1.38
Rate for Payer: BCBS Complete	$0.85
Rate for Payer: Cash Price	$1.70
Rate for Payer: Cofinity Commercial	$1.48
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Medicare Advantage	$1.48
Rate for Payer: Encore Health Key Benefits Commercial	$1.70
Rate for Payer: Healthscope Commercial	$1.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.80
Rate for Payer: PHP Commercial	$1.80
Rate for Payer: Priority Health Cigna Priority Health	$1.38
Rate for Payer: Priority Health SBD	$1.34

ATENOLOL 50 MG TABLET

Facility

$75.20

Service Code	NDC 00093075201
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna Medicare	$37.60
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: BCBS Complete	$30.08
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Cofinity Medicare Advantage	$52.64
Rate for Payer: Encore Health Key Benefits Commercial	$60.16
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$48.88
Rate for Payer: Priority Health SBD	$47.38

ATENOLOL 50 MG TABLET

Facility

$75.20

Service Code	NDC 00093075201
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$47.38
Max. Negotiated Rate	$67.68
Rate for Payer: Aetna Commercial	$63.92
Rate for Payer: Aetna New Business (MI Preferred)	$48.88
Rate for Payer: Cash Price	$60.16
Rate for Payer: Cofinity Commercial	$52.64
Rate for Payer: Cofinity Commercial	$64.67
Rate for Payer: Cofinity Medicare Advantage	$52.64
Rate for Payer: Encore Health Key Benefits Commercial	$60.16
Rate for Payer: Healthscope Commercial	$67.68
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$63.92
Rate for Payer: PHP Commercial	$63.92
Rate for Payer: Priority Health Cigna Priority Health	$48.88
Rate for Payer: Priority Health SBD	$47.38

ATENOLOL 50 MG TABLET

Facility

$211.50

Service Code	NDC 51079068420
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$84.60
Max. Negotiated Rate	$190.35
Rate for Payer: Aetna Commercial	$179.78
Rate for Payer: Aetna Medicare	$105.75
Rate for Payer: Aetna New Business (MI Preferred)	$137.47
Rate for Payer: BCBS Complete	$84.60
Rate for Payer: Cash Price	$169.20
Rate for Payer: Cofinity Commercial	$148.05
Rate for Payer: Cofinity Commercial	$181.89
Rate for Payer: Cofinity Medicare Advantage	$148.05
Rate for Payer: Encore Health Key Benefits Commercial	$169.20
Rate for Payer: Healthscope Commercial	$190.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.78
Rate for Payer: PHP Commercial	$179.78
Rate for Payer: Priority Health Cigna Priority Health	$137.47
Rate for Payer: Priority Health SBD	$133.25

ATENOLOL 50 MG TABLET

Facility

$155.10

Service Code	NDC 00378023101
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$97.71
Max. Negotiated Rate	$139.59
Rate for Payer: Aetna Commercial	$131.84
Rate for Payer: Aetna New Business (MI Preferred)	$100.81
Rate for Payer: Cash Price	$124.08
Rate for Payer: Cofinity Commercial	$108.57
Rate for Payer: Cofinity Commercial	$133.39
Rate for Payer: Cofinity Medicare Advantage	$108.57
Rate for Payer: Encore Health Key Benefits Commercial	$124.08
Rate for Payer: Healthscope Commercial	$139.59
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$131.84
Rate for Payer: PHP Commercial	$131.84
Rate for Payer: Priority Health Cigna Priority Health	$100.81
Rate for Payer: Priority Health SBD	$97.71

ATENOLOL 50 MG TABLET

Facility

$2.12

Service Code	NDC 51079068401
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$1.91
Rate for Payer: Aetna Commercial	$1.80
Rate for Payer: Aetna New Business (MI Preferred)	$1.38
Rate for Payer: Cash Price	$1.70
Rate for Payer: Cofinity Commercial	$1.48
Rate for Payer: Cofinity Commercial	$1.82
Rate for Payer: Cofinity Medicare Advantage	$1.48
Rate for Payer: Encore Health Key Benefits Commercial	$1.70
Rate for Payer: Healthscope Commercial	$1.91
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.80
Rate for Payer: PHP Commercial	$1.80
Rate for Payer: Priority Health Cigna Priority Health	$1.38
Rate for Payer: Priority Health SBD	$1.34

ATENOLOL 50 MG TABLET

Facility

$211.50

Service Code	NDC 51079068420
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$133.25
Max. Negotiated Rate	$190.35
Rate for Payer: Aetna Commercial	$179.78
Rate for Payer: Aetna New Business (MI Preferred)	$137.47
Rate for Payer: Cash Price	$169.20
Rate for Payer: Cofinity Commercial	$148.05
Rate for Payer: Cofinity Commercial	$181.89
Rate for Payer: Cofinity Medicare Advantage	$148.05
Rate for Payer: Encore Health Key Benefits Commercial	$169.20
Rate for Payer: Healthscope Commercial	$190.35
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$179.78
Rate for Payer: PHP Commercial	$179.78
Rate for Payer: Priority Health Cigna Priority Health	$137.47
Rate for Payer: Priority Health SBD	$133.25

ATENOLOL 50 MG TABLET

Facility

$68.15

Service Code	NDC 65862016901
Hospital Charge Code	718
Hospital Revenue Code	637
Min. Negotiated Rate	$27.26
Max. Negotiated Rate	$61.34
Rate for Payer: Aetna Commercial	$57.93
Rate for Payer: Aetna Medicare	$34.08
Rate for Payer: Aetna New Business (MI Preferred)	$44.30
Rate for Payer: BCBS Complete	$27.26
Rate for Payer: Cash Price	$54.52
Rate for Payer: Cofinity Commercial	$47.70
Rate for Payer: Cofinity Commercial	$58.61
Rate for Payer: Cofinity Medicare Advantage	$47.70
Rate for Payer: Encore Health Key Benefits Commercial	$54.52
Rate for Payer: Healthscope Commercial	$61.34
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$57.93
Rate for Payer: PHP Commercial	$57.93
Rate for Payer: Priority Health Cigna Priority Health	$44.30
Rate for Payer: Priority Health SBD	$42.93

ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION

Facility

$50,520.68

Service Code	HCPCS J9022
Hospital Charge Code	179035
Hospital Revenue Code	636
Min. Negotiated Rate	$48.96
Max. Negotiated Rate	$45,468.61
Rate for Payer: Aetna Commercial	$42,942.58
Rate for Payer: Aetna Medicare	$94.99
Rate for Payer: Aetna New Business (MI Preferred)	$32,838.44
Rate for Payer: Allen County Amish Medical Aid Commercial	$114.17
Rate for Payer: Amish Plain Church Group Commercial	$114.17
Rate for Payer: BCBS Complete	$51.41
Rate for Payer: BCBS MAPPO	$91.34
Rate for Payer: BCN Medicare Advantage	$91.34
Rate for Payer: Cash Price	$40,416.54
Rate for Payer: Cash Price	$40,416.54
Rate for Payer: Cofinity Commercial	$43,447.78
Rate for Payer: Cofinity Commercial	$35,364.48
Rate for Payer: Cofinity Medicare Advantage	$35,364.48
Rate for Payer: Encore Health Key Benefits Commercial	$40,416.54
Rate for Payer: Health Alliance Plan Medicare Advantage	$91.34
Rate for Payer: Healthscope Commercial	$45,468.61
Rate for Payer: Mclaren Medicaid	$48.96
Rate for Payer: Mclaren Medicare	$91.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$95.91
Rate for Payer: Meridian Medicaid	$51.41
Rate for Payer: MI Amish Medical Board Commercial	$105.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42,942.58
Rate for Payer: PACE Medicare	$86.77
Rate for Payer: PACE SWMI	$91.34
Rate for Payer: PHP Commercial	$42,942.58
Rate for Payer: PHP Medicare Advantage	$91.34
Rate for Payer: Priority Health Choice Medicaid	$48.96
Rate for Payer: Priority Health Cigna Priority Health	$32,838.44
Rate for Payer: Priority Health Medicare	$91.34
Rate for Payer: Priority Health SBD	$31,828.03
Rate for Payer: Railroad Medicare Medicare	$91.34
Rate for Payer: UHC All Payor (Choice/PPO)	$257.11
Rate for Payer: UHC Dual Complete DSNP	$91.34
Rate for Payer: UHC Medicare Advantage	$91.34
Rate for Payer: UHCCP Medicaid	$51.42
Rate for Payer: VA VA	$91.34

ATEZOLIZUMAB 1,200 MG/20 ML (60 MG/ML) INTRAVENOUS SOLUTION

Facility

$50,520.68

Service Code	HCPCS J9022
Hospital Charge Code	179035
Hospital Revenue Code	636
Min. Negotiated Rate	$31,828.03
Max. Negotiated Rate	$45,468.61
Rate for Payer: Aetna Commercial	$42,942.58
Rate for Payer: Aetna New Business (MI Preferred)	$32,838.44
Rate for Payer: Cash Price	$40,416.54
Rate for Payer: Cofinity Commercial	$35,364.48
Rate for Payer: Cofinity Commercial	$43,447.78
Rate for Payer: Cofinity Medicare Advantage	$35,364.48
Rate for Payer: Encore Health Key Benefits Commercial	$40,416.54
Rate for Payer: Healthscope Commercial	$45,468.61
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$42,942.58
Rate for Payer: PHP Commercial	$42,942.58
Rate for Payer: Priority Health Cigna Priority Health	$32,838.44
Rate for Payer: Priority Health SBD	$31,828.03

ATEZOLIZUMAB 840 MG/14 ML (60 MG/ML) INTRAVENOUS SOLUTION

Facility

$35,364.48

Service Code	HCPCS J9022
Hospital Charge Code	189931
Hospital Revenue Code	636
Min. Negotiated Rate	$48.96
Max. Negotiated Rate	$31,828.03
Rate for Payer: Aetna Commercial	$30,059.81
Rate for Payer: Aetna Medicare	$94.99
Rate for Payer: Aetna New Business (MI Preferred)	$22,986.91
Rate for Payer: Allen County Amish Medical Aid Commercial	$114.17
Rate for Payer: Amish Plain Church Group Commercial	$114.17
Rate for Payer: BCBS Complete	$51.41
Rate for Payer: BCBS MAPPO	$91.34
Rate for Payer: BCN Medicare Advantage	$91.34
Rate for Payer: Cash Price	$28,291.58
Rate for Payer: Cash Price	$28,291.58
Rate for Payer: Cofinity Commercial	$30,413.45
Rate for Payer: Cofinity Commercial	$24,755.14
Rate for Payer: Cofinity Medicare Advantage	$24,755.14
Rate for Payer: Encore Health Key Benefits Commercial	$28,291.58
Rate for Payer: Health Alliance Plan Medicare Advantage	$91.34
Rate for Payer: Healthscope Commercial	$31,828.03
Rate for Payer: Mclaren Medicaid	$48.96
Rate for Payer: Mclaren Medicare	$91.34
Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage	$95.91
Rate for Payer: Meridian Medicaid	$51.41
Rate for Payer: MI Amish Medical Board Commercial	$105.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$30,059.81
Rate for Payer: PACE Medicare	$86.77
Rate for Payer: PACE SWMI	$91.34
Rate for Payer: PHP Commercial	$30,059.81
Rate for Payer: PHP Medicare Advantage	$91.34
Rate for Payer: Priority Health Choice Medicaid	$48.96
Rate for Payer: Priority Health Cigna Priority Health	$22,986.91
Rate for Payer: Priority Health Medicare	$91.34
Rate for Payer: Priority Health SBD	$22,279.62
Rate for Payer: Railroad Medicare Medicare	$91.34
Rate for Payer: UHC All Payor (Choice/PPO)	$257.11
Rate for Payer: UHC Dual Complete DSNP	$91.34
Rate for Payer: UHC Medicare Advantage	$91.34
Rate for Payer: UHCCP Medicaid	$51.42
Rate for Payer: VA VA	$91.34

ATORVASTATIN 10 MG TABLET

Facility

$451.20

Service Code	NDC 68084009701
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$284.26
Max. Negotiated Rate	$406.08
Rate for Payer: Aetna Commercial	$383.52
Rate for Payer: Aetna New Business (MI Preferred)	$293.28
Rate for Payer: Cash Price	$360.96
Rate for Payer: Cofinity Commercial	$315.84
Rate for Payer: Cofinity Commercial	$388.03
Rate for Payer: Cofinity Medicare Advantage	$315.84
Rate for Payer: Encore Health Key Benefits Commercial	$360.96
Rate for Payer: Healthscope Commercial	$406.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$383.52
Rate for Payer: PHP Commercial	$383.52
Rate for Payer: Priority Health Cigna Priority Health	$293.28
Rate for Payer: Priority Health SBD	$284.26

ATORVASTATIN 10 MG TABLET

Facility

$235.00

Service Code	NDC 50268009315
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$148.05
Max. Negotiated Rate	$211.50
Rate for Payer: Aetna Commercial	$199.75
Rate for Payer: Aetna New Business (MI Preferred)	$152.75
Rate for Payer: Cash Price	$188.00
Rate for Payer: Cofinity Commercial	$164.50
Rate for Payer: Cofinity Commercial	$202.10
Rate for Payer: Cofinity Medicare Advantage	$164.50
Rate for Payer: Encore Health Key Benefits Commercial	$188.00
Rate for Payer: Healthscope Commercial	$211.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$199.75
Rate for Payer: PHP Commercial	$199.75
Rate for Payer: Priority Health Cigna Priority Health	$152.75
Rate for Payer: Priority Health SBD	$148.05

ATORVASTATIN 10 MG TABLET

Facility

$411.25

Service Code	NDC 00904629061
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$164.50
Max. Negotiated Rate	$370.12
Rate for Payer: Aetna Commercial	$349.56
Rate for Payer: Aetna Medicare	$205.62
Rate for Payer: Aetna New Business (MI Preferred)	$267.31
Rate for Payer: BCBS Complete	$164.50
Rate for Payer: Cash Price	$329.00
Rate for Payer: Cofinity Commercial	$287.88
Rate for Payer: Cofinity Commercial	$353.68
Rate for Payer: Cofinity Medicare Advantage	$287.88
Rate for Payer: Encore Health Key Benefits Commercial	$329.00
Rate for Payer: Healthscope Commercial	$370.12
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$349.56
Rate for Payer: PHP Commercial	$349.56
Rate for Payer: Priority Health Cigna Priority Health	$267.31
Rate for Payer: Priority Health SBD	$259.09

ATORVASTATIN 10 MG TABLET

Facility

$222.30

Service Code	NDC 51079020820
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$88.92
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 Commercial	$155.61
Rate for Payer: Cofinity Commercial	$191.18
Rate for Payer: Cofinity Medicare Advantage	$155.61
Rate for Payer: Encore Health Key Benefits Commercial	$177.84
Rate for Payer: Healthscope Commercial	$200.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$188.96
Rate for Payer: PHP Commercial	$188.96
Rate for Payer: Priority Health Cigna Priority Health	$144.50
Rate for Payer: Priority Health SBD	$140.05

ATORVASTATIN 10 MG TABLET

Facility

$4,180.26

Service Code	NDC 00071015540
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$2,633.56
Max. Negotiated Rate	$3,762.23
Rate for Payer: Aetna Commercial	$3,553.22
Rate for Payer: Aetna New Business (MI Preferred)	$2,717.17
Rate for Payer: Cash Price	$3,344.21
Rate for Payer: Cofinity Commercial	$2,926.18
Rate for Payer: Cofinity Commercial	$3,595.02
Rate for Payer: Cofinity Medicare Advantage	$2,926.18
Rate for Payer: Encore Health Key Benefits Commercial	$3,344.21
Rate for Payer: Healthscope Commercial	$3,762.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3,553.22
Rate for Payer: PHP Commercial	$3,553.22
Rate for Payer: Priority Health Cigna Priority Health	$2,717.17
Rate for Payer: Priority Health SBD	$2,633.56

ATORVASTATIN 10 MG TABLET

Facility

$235.00

Service Code	NDC 50268009315
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$211.50
Rate for Payer: Aetna Commercial	$199.75
Rate for Payer: Aetna Medicare	$117.50
Rate for Payer: Aetna New Business (MI Preferred)	$152.75
Rate for Payer: BCBS Complete	$94.00
Rate for Payer: Cash Price	$188.00
Rate for Payer: Cofinity Commercial	$164.50
Rate for Payer: Cofinity Commercial	$202.10
Rate for Payer: Cofinity Medicare Advantage	$164.50
Rate for Payer: Encore Health Key Benefits Commercial	$188.00
Rate for Payer: Healthscope Commercial	$211.50
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$199.75
Rate for Payer: PHP Commercial	$199.75
Rate for Payer: Priority Health Cigna Priority Health	$152.75
Rate for Payer: Priority Health SBD	$148.05

ATORVASTATIN 10 MG TABLET

Facility

$4.52

Service Code	NDC 68084009711
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$4.07
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna New Business (MI Preferred)	$2.94
Rate for Payer: Cash Price	$3.62
Rate for Payer: Cofinity Commercial	$3.16
Rate for Payer: Cofinity Commercial	$3.89
Rate for Payer: Cofinity Medicare Advantage	$3.16
Rate for Payer: Encore Health Key Benefits Commercial	$3.62
Rate for Payer: Healthscope Commercial	$4.07
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$3.84
Rate for Payer: PHP Commercial	$3.84
Rate for Payer: Priority Health Cigna Priority Health	$2.94
Rate for Payer: Priority Health SBD	$2.85

ATORVASTATIN 10 MG TABLET

Facility

$2.23

Service Code	NDC 51079020801
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare	$1.11
Rate for Payer: Aetna New Business (MI Preferred)	$1.45
Rate for Payer: BCBS Complete	$0.89
Rate for Payer: Cash Price	$1.78
Rate for Payer: Cofinity Commercial	$1.56
Rate for Payer: Cofinity Commercial	$1.92
Rate for Payer: Cofinity Medicare Advantage	$1.56
Rate for Payer: Encore Health Key Benefits Commercial	$1.78
Rate for Payer: Healthscope Commercial	$2.01
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$1.90
Rate for Payer: PHP Commercial	$1.90
Rate for Payer: Priority Health Cigna Priority Health	$1.45
Rate for Payer: Priority Health SBD	$1.40

ATORVASTATIN 10 MG TABLET

Facility

$4.70

Service Code	NDC 50268009311
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$4.23
Rate for Payer: Aetna Commercial	$4.00
Rate for Payer: Aetna Medicare	$2.35
Rate for Payer: Aetna New Business (MI Preferred)	$3.06
Rate for Payer: BCBS Complete	$1.88
Rate for Payer: Cash Price	$3.76
Rate for Payer: Cofinity Commercial	$3.29
Rate for Payer: Cofinity Commercial	$4.04
Rate for Payer: Cofinity Medicare Advantage	$3.29
Rate for Payer: Encore Health Key Benefits Commercial	$3.76
Rate for Payer: Healthscope Commercial	$4.23
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.00
Rate for Payer: PHP Commercial	$4.00
Rate for Payer: Priority Health Cigna Priority Health	$3.06
Rate for Payer: Priority Health SBD	$2.96

ATORVASTATIN 10 MG TABLET

Facility

$451.20

Service Code	NDC 68084009701
Hospital Charge Code	19176
Hospital Revenue Code	637
Min. Negotiated Rate	$180.48
Max. Negotiated Rate	$406.08
Rate for Payer: Aetna Commercial	$383.52
Rate for Payer: Aetna Medicare	$225.60
Rate for Payer: Aetna New Business (MI Preferred)	$293.28
Rate for Payer: BCBS Complete	$180.48
Rate for Payer: Cash Price	$360.96
Rate for Payer: Cofinity Commercial	$315.84
Rate for Payer: Cofinity Commercial	$388.03
Rate for Payer: Cofinity Medicare Advantage	$315.84
Rate for Payer: Encore Health Key Benefits Commercial	$360.96
Rate for Payer: Healthscope Commercial	$406.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$383.52
Rate for Payer: PHP Commercial	$383.52
Rate for Payer: Priority Health Cigna Priority Health	$293.28
Rate for Payer: Priority Health SBD	$284.26

Know your out-of-pocket cost for care.

All Charges