|
ATENOLOL 25 MG TABLET
|
Facility
|
OP
|
$404.20
|
|
|
Service Code
|
NDC 51079075920
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.26 |
| Max. Negotiated Rate |
$363.78 |
| Rate for Payer: Aetna Commercial |
$343.57
|
| Rate for Payer: Aetna Medicare |
$105.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.31
|
| Rate for Payer: BCBS Complete |
$74.82
|
| Rate for Payer: BCBS MAPPO |
$101.05
|
| Rate for Payer: BCBS Trust/PPO |
$332.29
|
| Rate for Payer: BCN Commercial |
$332.29
|
| Rate for Payer: BCN Medicare Advantage |
$101.05
|
| Rate for Payer: Cash Price |
$323.36
|
| Rate for Payer: Cofinity Commercial |
$347.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$323.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.05
|
| Rate for Payer: Healthscope Commercial |
$363.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$303.15
|
| Rate for Payer: Mclaren Medicaid |
$71.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.10
|
| Rate for Payer: Meridian Medicaid |
$74.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$343.57
|
| Rate for Payer: Nomi Health Commercial |
$331.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$303.15
|
| Rate for Payer: PACE Senior Care Partners |
$96.00
|
| Rate for Payer: PACE SWMI |
$101.05
|
| Rate for Payer: PHP Commercial |
$343.57
|
| Rate for Payer: PHP Medicare Advantage |
$101.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$351.65
|
| Rate for Payer: Priority Health Medicare |
$102.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$281.32
|
| Rate for Payer: Railroad Medicare Medicare |
$101.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.70
|
| Rate for Payer: UHC Core |
$337.51
|
| Rate for Payer: UHC Exchange |
$101.05
|
| Rate for Payer: UHC Medicaid |
$71.26
|
| Rate for Payer: UHC Medicare Advantage |
$101.05
|
| Rate for Payer: UHCCP Medicaid |
$71.26
|
| Rate for Payer: VA VA |
$101.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$303.15
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
IP
|
$75.20
|
|
|
Service Code
|
NDC 00093078701
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$52.34 |
| Max. Negotiated Rate |
$67.68 |
| Rate for Payer: Aetna Commercial |
$63.92
|
| Rate for Payer: BCBS Trust/PPO |
$62.11
|
| Rate for Payer: BCN Commercial |
$62.11
|
| Rate for Payer: Cash Price |
$60.16
|
| Rate for Payer: Cofinity Commercial |
$64.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.16
|
| Rate for Payer: Healthscope Commercial |
$67.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.92
|
| Rate for Payer: Nomi Health Commercial |
$61.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.40
|
| Rate for Payer: PHP Commercial |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.18
|
| Rate for Payer: UHC Core |
$62.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.40
|
|
|
ATENOLOL 25 MG TABLET
|
Facility
|
OP
|
$354.85
|
|
|
Service Code
|
NDC 00904718761
|
| Hospital Charge Code |
717
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$62.56 |
| Max. Negotiated Rate |
$319.37 |
| Rate for Payer: Aetna Commercial |
$301.62
|
| Rate for Payer: Aetna Medicare |
$92.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$110.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$110.89
|
| Rate for Payer: BCBS Complete |
$65.68
|
| Rate for Payer: BCBS MAPPO |
$88.71
|
| Rate for Payer: BCBS Trust/PPO |
$291.72
|
| Rate for Payer: BCN Commercial |
$291.72
|
| Rate for Payer: BCN Medicare Advantage |
$88.71
|
| Rate for Payer: Cash Price |
$283.88
|
| Rate for Payer: Cofinity Commercial |
$305.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.71
|
| Rate for Payer: Healthscope Commercial |
$319.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.14
|
| Rate for Payer: Mclaren Medicaid |
$62.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.15
|
| Rate for Payer: Meridian Medicaid |
$65.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$97.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.62
|
| Rate for Payer: Nomi Health Commercial |
$290.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$266.14
|
| Rate for Payer: PACE Senior Care Partners |
$84.28
|
| Rate for Payer: PACE SWMI |
$88.71
|
| Rate for Payer: PHP Commercial |
$301.62
|
| Rate for Payer: PHP Medicare Advantage |
$88.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.72
|
| Rate for Payer: Priority Health Medicare |
$89.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.98
|
| Rate for Payer: Railroad Medicare Medicare |
$88.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.27
|
| Rate for Payer: UHC Core |
$296.30
|
| Rate for Payer: UHC Exchange |
$88.71
|
| Rate for Payer: UHC Medicaid |
$62.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.71
|
| Rate for Payer: UHCCP Medicaid |
$62.56
|
| Rate for Payer: VA VA |
$88.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.14
|
|
|
ATENOLOL 50 MG TABLET
|
Facility
|
IP
|
$728.50
|
|
|
Service Code
|
NDC 00093075210
|
| Hospital Charge Code |
718
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$507.04 |
| Max. Negotiated Rate |
$655.65 |
| Rate for Payer: Aetna Commercial |
$619.23
|
| Rate for Payer: BCBS Trust/PPO |
$601.67
|
| Rate for Payer: BCN Commercial |
$601.67
|
| Rate for Payer: Cash Price |
$582.80
|
| Rate for Payer: Cofinity Commercial |
$626.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.80
|
| Rate for Payer: Healthscope Commercial |
$655.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.23
|
| Rate for Payer: Nomi Health Commercial |
$597.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.38
|
| Rate for Payer: PHP Commercial |
$619.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.08
|
| Rate for Payer: UHC Core |
$608.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.38
|
|
|
ATENOLOL 50 MG TABLET
|
Facility
|
IP
|
$2.47
|
|
|
Service Code
|
NDC 51079068401
|
| Hospital Charge Code |
718
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.72 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: BCBS Trust/PPO |
$2.04
|
| Rate for Payer: BCN Commercial |
$2.04
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Healthscope Commercial |
$2.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.10
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.85
|
| Rate for Payer: PHP Commercial |
$2.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.17
|
| Rate for Payer: UHC Core |
$2.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.85
|
|
|
ATENOLOL 50 MG TABLET
|
Facility
|
OP
|
$2.47
|
|
|
Service Code
|
NDC 51079068401
|
| Hospital Charge Code |
718
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.22 |
| Rate for Payer: Aetna Commercial |
$2.10
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.77
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.03
|
| Rate for Payer: BCN Commercial |
$2.03
|
| Rate for Payer: BCN Medicare Advantage |
$0.62
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.62
|
| Rate for Payer: Healthscope Commercial |
$2.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.85
|
| Rate for Payer: Mclaren Medicaid |
$0.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.65
|
| Rate for Payer: Meridian Medicaid |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.10
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.85
|
| Rate for Payer: PACE Senior Care Partners |
$0.59
|
| Rate for Payer: PACE SWMI |
$0.62
|
| Rate for Payer: PHP Commercial |
$2.10
|
| Rate for Payer: PHP Medicare Advantage |
$0.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.15
|
| Rate for Payer: Priority Health Medicare |
$0.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.72
|
| Rate for Payer: Railroad Medicare Medicare |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.17
|
| Rate for Payer: UHC Core |
$2.06
|
| Rate for Payer: UHC Exchange |
$0.62
|
| Rate for Payer: UHC Medicaid |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.62
|
| Rate for Payer: UHCCP Medicaid |
$0.44
|
| Rate for Payer: VA VA |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.85
|
|
|
ATENOLOL 50 MG TABLET
|
Facility
|
OP
|
$728.50
|
|
|
Service Code
|
NDC 00093075210
|
| Hospital Charge Code |
718
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$128.43 |
| Max. Negotiated Rate |
$655.65 |
| Rate for Payer: Aetna Commercial |
$619.23
|
| Rate for Payer: Aetna Medicare |
$189.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$227.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$227.66
|
| Rate for Payer: BCBS Complete |
$134.85
|
| Rate for Payer: BCBS MAPPO |
$182.12
|
| Rate for Payer: BCBS Trust/PPO |
$598.90
|
| Rate for Payer: BCN Commercial |
$598.90
|
| Rate for Payer: BCN Medicare Advantage |
$182.12
|
| Rate for Payer: Cash Price |
$582.80
|
| Rate for Payer: Cofinity Commercial |
$626.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.12
|
| Rate for Payer: Healthscope Commercial |
$655.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.38
|
| Rate for Payer: Mclaren Medicaid |
$128.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.23
|
| Rate for Payer: Meridian Medicaid |
$134.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$209.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.23
|
| Rate for Payer: Nomi Health Commercial |
$597.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$546.38
|
| Rate for Payer: PACE Senior Care Partners |
$173.02
|
| Rate for Payer: PACE SWMI |
$182.12
|
| Rate for Payer: PHP Commercial |
$619.23
|
| Rate for Payer: PHP Medicare Advantage |
$182.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$128.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$633.79
|
| Rate for Payer: Priority Health Medicare |
$183.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.04
|
| Rate for Payer: Railroad Medicare Medicare |
$182.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.08
|
| Rate for Payer: UHC Core |
$608.30
|
| Rate for Payer: UHC Exchange |
$182.12
|
| Rate for Payer: UHC Medicaid |
$128.43
|
| Rate for Payer: UHC Medicare Advantage |
$182.12
|
| Rate for Payer: UHCCP Medicaid |
$128.43
|
| Rate for Payer: VA VA |
$182.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.38
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$2.16
|
|
|
Service Code
|
NDC 51079020801
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: Aetna Medicare |
$0.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.68
|
| Rate for Payer: BCBS Complete |
$0.40
|
| Rate for Payer: BCBS MAPPO |
$0.54
|
| Rate for Payer: BCBS Trust/PPO |
$1.78
|
| Rate for Payer: BCN Commercial |
$1.78
|
| Rate for Payer: BCN Medicare Advantage |
$0.54
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cofinity Commercial |
$1.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.54
|
| Rate for Payer: Healthscope Commercial |
$1.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.62
|
| Rate for Payer: Mclaren Medicaid |
$0.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.57
|
| Rate for Payer: Meridian Medicaid |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Nomi Health Commercial |
$1.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: PACE Senior Care Partners |
$0.51
|
| Rate for Payer: PACE SWMI |
$0.54
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: PHP Medicare Advantage |
$0.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.88
|
| Rate for Payer: Priority Health Medicare |
$0.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.50
|
| Rate for Payer: Railroad Medicare Medicare |
$0.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.90
|
| Rate for Payer: UHC Core |
$1.80
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.38
|
| Rate for Payer: UHC Medicare Advantage |
$0.54
|
| Rate for Payer: UHCCP Medicaid |
$0.38
|
| Rate for Payer: VA VA |
$0.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.62
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$195.70
|
|
|
Service Code
|
NDC 00904629061
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$176.13 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: Aetna Medicare |
$50.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.16
|
| Rate for Payer: BCBS Complete |
$36.22
|
| Rate for Payer: BCBS MAPPO |
$48.92
|
| Rate for Payer: BCBS Trust/PPO |
$160.88
|
| Rate for Payer: BCN Commercial |
$160.88
|
| Rate for Payer: BCN Medicare Advantage |
$48.92
|
| Rate for Payer: Cash Price |
$156.56
|
| Rate for Payer: Cofinity Commercial |
$168.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.92
|
| Rate for Payer: Healthscope Commercial |
$176.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.78
|
| Rate for Payer: Mclaren Medicaid |
$34.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.37
|
| Rate for Payer: Meridian Medicaid |
$36.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: Nomi Health Commercial |
$160.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.78
|
| Rate for Payer: PACE Senior Care Partners |
$46.48
|
| Rate for Payer: PACE SWMI |
$48.92
|
| Rate for Payer: PHP Commercial |
$166.34
|
| Rate for Payer: PHP Medicare Advantage |
$48.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$170.26
|
| Rate for Payer: Priority Health Medicare |
$49.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.21
|
| Rate for Payer: Railroad Medicare Medicare |
$48.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.22
|
| Rate for Payer: UHC Core |
$163.41
|
| Rate for Payer: UHC Exchange |
$48.92
|
| Rate for Payer: UHC Medicaid |
$34.50
|
| Rate for Payer: UHC Medicare Advantage |
$48.92
|
| Rate for Payer: UHCCP Medicaid |
$34.50
|
| Rate for Payer: VA VA |
$48.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.78
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$195.70
|
|
|
Service Code
|
NDC 00904629061
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$136.21 |
| Max. Negotiated Rate |
$176.13 |
| Rate for Payer: Aetna Commercial |
$166.34
|
| Rate for Payer: BCBS Trust/PPO |
$161.63
|
| Rate for Payer: BCN Commercial |
$161.63
|
| Rate for Payer: Cash Price |
$156.56
|
| 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: Lakeland Regional Health Systems Commercial |
$146.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$166.34
|
| Rate for Payer: Nomi Health Commercial |
$160.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$146.78
|
| Rate for Payer: PHP Commercial |
$166.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$170.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.22
|
| Rate for Payer: UHC Core |
$163.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.78
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$215.65
|
|
|
Service Code
|
NDC 51079020820
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$150.09 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: BCBS Trust/PPO |
$178.11
|
| Rate for Payer: BCN Commercial |
$178.11
|
| Rate for Payer: Cash Price |
$172.52
|
| 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: Lakeland Regional Health Systems Commercial |
$161.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Nomi Health Commercial |
$176.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.77
|
| Rate for Payer: UHC Core |
$180.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.74
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$215.65
|
|
|
Service Code
|
NDC 51079020820
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$38.02 |
| Max. Negotiated Rate |
$194.09 |
| Rate for Payer: Aetna Commercial |
$183.30
|
| Rate for Payer: Aetna Medicare |
$56.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.39
|
| Rate for Payer: BCBS Complete |
$39.92
|
| Rate for Payer: BCBS MAPPO |
$53.91
|
| Rate for Payer: BCBS Trust/PPO |
$177.29
|
| Rate for Payer: BCN Commercial |
$177.29
|
| Rate for Payer: BCN Medicare Advantage |
$53.91
|
| Rate for Payer: Cash Price |
$172.52
|
| Rate for Payer: Cofinity Commercial |
$185.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$172.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.91
|
| Rate for Payer: Healthscope Commercial |
$194.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$161.74
|
| Rate for Payer: Mclaren Medicaid |
$38.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$56.61
|
| Rate for Payer: Meridian Medicaid |
$39.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$183.30
|
| Rate for Payer: Nomi Health Commercial |
$176.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$161.74
|
| Rate for Payer: PACE Senior Care Partners |
$51.22
|
| Rate for Payer: PACE SWMI |
$53.91
|
| Rate for Payer: PHP Commercial |
$183.30
|
| Rate for Payer: PHP Medicare Advantage |
$53.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$187.62
|
| Rate for Payer: Priority Health Medicare |
$54.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.09
|
| Rate for Payer: Railroad Medicare Medicare |
$53.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.77
|
| Rate for Payer: UHC Core |
$180.07
|
| Rate for Payer: UHC Exchange |
$53.91
|
| Rate for Payer: UHC Medicaid |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$53.91
|
| Rate for Payer: UHCCP Medicaid |
$38.02
|
| Rate for Payer: VA VA |
$53.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$161.74
|
|
|
ATORVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$2.16
|
|
|
Service Code
|
NDC 51079020801
|
| Hospital Charge Code |
19176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.50 |
| Max. Negotiated Rate |
$1.94 |
| Rate for Payer: Aetna Commercial |
$1.84
|
| Rate for Payer: BCBS Trust/PPO |
$1.78
|
| Rate for Payer: BCN Commercial |
$1.78
|
| Rate for Payer: Cash Price |
$1.73
|
| 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: Lakeland Regional Health Systems Commercial |
$1.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.84
|
| Rate for Payer: Nomi Health Commercial |
$1.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.62
|
| Rate for Payer: PHP Commercial |
$1.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.90
|
| Rate for Payer: UHC Core |
$1.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.62
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$2.48
|
|
|
Service Code
|
NDC 68084009811
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.78
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.04
|
| Rate for Payer: BCN Commercial |
$2.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.62
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.62
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Mclaren Medicaid |
$0.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.65
|
| Rate for Payer: Meridian Medicaid |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PACE Senior Care Partners |
$0.59
|
| Rate for Payer: PACE SWMI |
$0.62
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: PHP Medicare Advantage |
$0.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Medicare |
$0.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: UHC Exchange |
$0.62
|
| Rate for Payer: UHC Medicaid |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.62
|
| Rate for Payer: UHCCP Medicaid |
$0.44
|
| Rate for Payer: VA VA |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$247.95
|
|
|
Service Code
|
NDC 68084009801
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$43.71 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna Medicare |
$64.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.48
|
| Rate for Payer: BCBS Complete |
$45.90
|
| Rate for Payer: BCBS MAPPO |
$61.99
|
| Rate for Payer: BCBS Trust/PPO |
$203.84
|
| Rate for Payer: BCN Commercial |
$203.84
|
| Rate for Payer: BCN Medicare Advantage |
$61.99
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Commercial |
$213.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$198.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.99
|
| Rate for Payer: Healthscope Commercial |
$223.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.96
|
| Rate for Payer: Mclaren Medicaid |
$43.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.09
|
| Rate for Payer: Meridian Medicaid |
$45.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Nomi Health Commercial |
$203.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PACE Senior Care Partners |
$58.89
|
| Rate for Payer: PACE SWMI |
$61.99
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: PHP Medicare Advantage |
$61.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.72
|
| Rate for Payer: Priority Health Medicare |
$62.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.57
|
| Rate for Payer: Railroad Medicare Medicare |
$61.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.20
|
| Rate for Payer: UHC Core |
$207.04
|
| Rate for Payer: UHC Exchange |
$61.99
|
| Rate for Payer: UHC Medicaid |
$43.71
|
| Rate for Payer: UHC Medicare Advantage |
$61.99
|
| Rate for Payer: UHCCP Medicaid |
$43.71
|
| Rate for Payer: VA VA |
$61.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.96
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$2.48
|
|
|
Service Code
|
NDC 51079020901
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.78
|
| Rate for Payer: BCBS Complete |
$0.46
|
| Rate for Payer: BCBS MAPPO |
$0.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.04
|
| Rate for Payer: BCN Commercial |
$2.04
|
| Rate for Payer: BCN Medicare Advantage |
$0.62
|
| Rate for Payer: Cash Price |
$1.98
|
| Rate for Payer: Cofinity Commercial |
$2.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.62
|
| Rate for Payer: Healthscope Commercial |
$2.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Mclaren Medicaid |
$0.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.65
|
| Rate for Payer: Meridian Medicaid |
$0.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PACE Senior Care Partners |
$0.59
|
| Rate for Payer: PACE SWMI |
$0.62
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: PHP Medicare Advantage |
$0.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Medicare |
$0.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: Railroad Medicare Medicare |
$0.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: UHC Exchange |
$0.62
|
| Rate for Payer: UHC Medicaid |
$0.44
|
| Rate for Payer: UHC Medicare Advantage |
$0.62
|
| Rate for Payer: UHCCP Medicaid |
$0.44
|
| Rate for Payer: VA VA |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$225.15
|
|
|
Service Code
|
NDC 00904629161
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.69 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna Medicare |
$58.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.36
|
| Rate for Payer: BCBS Complete |
$41.68
|
| Rate for Payer: BCBS MAPPO |
$56.29
|
| Rate for Payer: BCBS Trust/PPO |
$185.10
|
| Rate for Payer: BCN Commercial |
$185.10
|
| Rate for Payer: BCN Medicare Advantage |
$56.29
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Commercial |
$193.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.29
|
| Rate for Payer: Healthscope Commercial |
$202.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Mclaren Medicaid |
$39.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.10
|
| Rate for Payer: Meridian Medicaid |
$41.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Nomi Health Commercial |
$184.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PACE Senior Care Partners |
$53.47
|
| Rate for Payer: PACE SWMI |
$56.29
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: PHP Medicare Advantage |
$56.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.88
|
| Rate for Payer: Priority Health Medicare |
$56.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.70
|
| Rate for Payer: Railroad Medicare Medicare |
$56.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.13
|
| Rate for Payer: UHC Core |
$188.00
|
| Rate for Payer: UHC Exchange |
$56.29
|
| Rate for Payer: UHC Medicaid |
$39.69
|
| Rate for Payer: UHC Medicare Advantage |
$56.29
|
| Rate for Payer: UHCCP Medicaid |
$39.69
|
| Rate for Payer: VA VA |
$56.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$247.95
|
|
|
Service Code
|
NDC 68084009801
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.57 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: BCBS Trust/PPO |
$204.78
|
| Rate for Payer: BCN Commercial |
$204.78
|
| Rate for Payer: Cash Price |
$198.36
|
| 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: Lakeland Regional Health Systems Commercial |
$185.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Nomi Health Commercial |
$203.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$215.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.20
|
| Rate for Payer: UHC Core |
$207.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.96
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 00904629161
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$156.70 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: BCBS Trust/PPO |
$185.95
|
| Rate for Payer: BCN Commercial |
$185.95
|
| Rate for Payer: Cash Price |
$180.12
|
| 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: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Nomi Health Commercial |
$184.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.13
|
| Rate for Payer: UHC Core |
$188.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$2.48
|
|
|
Service Code
|
NDC 51079020901
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: BCBS Trust/PPO |
$2.05
|
| Rate for Payer: BCN Commercial |
$2.05
|
| Rate for Payer: Cash Price |
$1.98
|
| 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: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$2.48
|
|
|
Service Code
|
NDC 68084009811
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.73 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Aetna Commercial |
$2.11
|
| Rate for Payer: BCBS Trust/PPO |
$2.05
|
| Rate for Payer: BCN Commercial |
$2.05
|
| Rate for Payer: Cash Price |
$1.98
|
| 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: Lakeland Regional Health Systems Commercial |
$1.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.11
|
| Rate for Payer: Nomi Health Commercial |
$2.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.86
|
| Rate for Payer: PHP Commercial |
$2.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.86
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$1,245.50
|
|
|
Service Code
|
NDC 60505258008
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$219.58 |
| Max. Negotiated Rate |
$1,120.95 |
| Rate for Payer: Aetna Commercial |
$1,058.67
|
| Rate for Payer: Aetna Medicare |
$323.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$389.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$389.22
|
| Rate for Payer: BCBS Complete |
$230.54
|
| Rate for Payer: BCBS MAPPO |
$311.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.93
|
| Rate for Payer: BCN Commercial |
$1,023.93
|
| Rate for Payer: BCN Medicare Advantage |
$311.38
|
| Rate for Payer: Cash Price |
$996.40
|
| Rate for Payer: Cofinity Commercial |
$1,071.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$996.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.38
|
| Rate for Payer: Healthscope Commercial |
$1,120.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$934.12
|
| Rate for Payer: Mclaren Medicaid |
$219.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.94
|
| Rate for Payer: Meridian Medicaid |
$230.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$358.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$342.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,058.67
|
| Rate for Payer: Nomi Health Commercial |
$1,021.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$934.12
|
| Rate for Payer: PACE Senior Care Partners |
$295.81
|
| Rate for Payer: PACE SWMI |
$311.38
|
| Rate for Payer: PHP Commercial |
$1,058.67
|
| Rate for Payer: PHP Medicare Advantage |
$311.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$219.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,083.59
|
| Rate for Payer: Priority Health Medicare |
$314.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.87
|
| Rate for Payer: Railroad Medicare Medicare |
$311.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.04
|
| Rate for Payer: UHC Core |
$1,039.99
|
| Rate for Payer: UHC Exchange |
$311.38
|
| Rate for Payer: UHC Medicaid |
$219.58
|
| Rate for Payer: UHC Medicare Advantage |
$311.38
|
| Rate for Payer: UHCCP Medicaid |
$219.58
|
| Rate for Payer: VA VA |
$311.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$934.12
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$1,245.50
|
|
|
Service Code
|
NDC 60505258008
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$866.87 |
| Max. Negotiated Rate |
$1,120.95 |
| Rate for Payer: Aetna Commercial |
$1,058.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,028.66
|
| Rate for Payer: BCN Commercial |
$1,028.66
|
| Rate for Payer: Cash Price |
$996.40
|
| Rate for Payer: Cofinity Commercial |
$1,071.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$996.40
|
| Rate for Payer: Healthscope Commercial |
$1,120.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$934.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,058.67
|
| Rate for Payer: Nomi Health Commercial |
$1,021.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$934.12
|
| Rate for Payer: PHP Commercial |
$1,058.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,083.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$866.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.04
|
| Rate for Payer: UHC Core |
$1,039.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$934.12
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$226.10
|
|
|
Service Code
|
NDC 00904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.86 |
| Max. Negotiated Rate |
$203.49 |
| Rate for Payer: Aetna Commercial |
$192.19
|
| Rate for Payer: Aetna Medicare |
$58.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.66
|
| Rate for Payer: BCBS Complete |
$41.85
|
| Rate for Payer: BCBS MAPPO |
$56.52
|
| Rate for Payer: BCBS Trust/PPO |
$185.88
|
| Rate for Payer: BCN Commercial |
$185.88
|
| Rate for Payer: BCN Medicare Advantage |
$56.52
|
| Rate for Payer: Cash Price |
$180.88
|
| Rate for Payer: Cofinity Commercial |
$194.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.52
|
| Rate for Payer: Healthscope Commercial |
$203.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.57
|
| Rate for Payer: Mclaren Medicaid |
$39.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.35
|
| Rate for Payer: Meridian Medicaid |
$41.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Nomi Health Commercial |
$185.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: PACE Senior Care Partners |
$53.70
|
| Rate for Payer: PACE SWMI |
$56.52
|
| Rate for Payer: PHP Commercial |
$192.19
|
| Rate for Payer: PHP Medicare Advantage |
$56.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.71
|
| Rate for Payer: Priority Health Medicare |
$57.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.37
|
| Rate for Payer: Railroad Medicare Medicare |
$56.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.97
|
| Rate for Payer: UHC Core |
$188.79
|
| Rate for Payer: UHC Exchange |
$56.52
|
| Rate for Payer: UHC Medicaid |
$39.86
|
| Rate for Payer: UHC Medicare Advantage |
$56.52
|
| Rate for Payer: UHCCP Medicaid |
$39.86
|
| Rate for Payer: VA VA |
$56.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.57
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$226.10
|
|
|
Service Code
|
NDC 00904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$157.37 |
| Max. Negotiated Rate |
$203.49 |
| Rate for Payer: Aetna Commercial |
$192.19
|
| Rate for Payer: BCBS Trust/PPO |
$186.74
|
| Rate for Payer: BCN Commercial |
$186.74
|
| Rate for Payer: Cash Price |
$180.88
|
| 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: Lakeland Regional Health Systems Commercial |
$169.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Nomi Health Commercial |
$185.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: PHP Commercial |
$192.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$196.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.97
|
| Rate for Payer: UHC Core |
$188.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.57
|
|
