|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$130.32
|
|
|
Service Code
|
NDC 50268070915
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$57.34 |
| Max. Negotiated Rate |
$117.29 |
| Rate for Payer: Aetna American Axle |
$84.71
|
| Rate for Payer: Aetna Commercial |
$110.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.71
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Cofinity Advantage |
$91.22
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$117.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.74
|
| Rate for Payer: PHP Commercial |
$110.77
|
| Rate for Payer: Priority Health SBD |
$82.10
|
| Rate for Payer: UMR Bronson Commercial |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.74
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$175.55
|
|
|
Service Code
|
NDC 31722088390
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.24 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Advantage |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.66
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$77.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$130.32
|
|
|
Service Code
|
NDC 50268070915
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.22 |
| Max. Negotiated Rate |
$117.29 |
| Rate for Payer: Aetna American Axle |
$84.71
|
| Rate for Payer: Aetna Commercial |
$110.77
|
| Rate for Payer: Aetna Medicare |
$65.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.71
|
| Rate for Payer: BCBS Complete |
$52.13
|
| Rate for Payer: Cash Price |
$104.26
|
| Rate for Payer: Cofinity Advantage |
$91.22
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.26
|
| Rate for Payer: Healthscope Commercial |
$117.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.74
|
| Rate for Payer: PHP Commercial |
$110.77
|
| Rate for Payer: Priority Health SBD |
$82.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.71
|
| Rate for Payer: UHC Core |
$67.90
|
| Rate for Payer: UHC Exchange |
$51.22
|
| Rate for Payer: UMR Bronson Commercial |
$48.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.74
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$2.61
|
|
|
Service Code
|
NDC 50268070911
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Aetna American Axle |
$1.70
|
| Rate for Payer: Aetna Commercial |
$2.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.70
|
| Rate for Payer: Cash Price |
$2.09
|
| Rate for Payer: Cofinity Advantage |
$1.83
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.09
|
| Rate for Payer: Healthscope Commercial |
$2.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.96
|
| Rate for Payer: PHP Commercial |
$2.22
|
| Rate for Payer: Priority Health SBD |
$1.64
|
| Rate for Payer: UMR Bronson Commercial |
$1.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.96
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$6.39
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Aetna American Axle |
$4.15
|
| Rate for Payer: Aetna Commercial |
$5.43
|
| Rate for Payer: Aetna Medicare |
$3.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.15
|
| Rate for Payer: BCBS Complete |
$2.56
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cofinity Advantage |
$4.47
|
| Rate for Payer: Cofinity Commercial |
$5.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.11
|
| Rate for Payer: Healthscope Commercial |
$5.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.79
|
| Rate for Payer: PHP Commercial |
$5.43
|
| Rate for Payer: Priority Health SBD |
$4.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.15
|
| Rate for Payer: UHC Core |
$3.33
|
| Rate for Payer: UHC Exchange |
$2.51
|
| Rate for Payer: UMR Bronson Commercial |
$2.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.79
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$219.96
|
|
|
Service Code
|
NDC 13668018090
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$96.78 |
| Max. Negotiated Rate |
$197.96 |
| Rate for Payer: Aetna American Axle |
$142.97
|
| Rate for Payer: Aetna Commercial |
$186.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.97
|
| Rate for Payer: Cash Price |
$175.97
|
| Rate for Payer: Cofinity Advantage |
$153.97
|
| Rate for Payer: Cofinity Commercial |
$189.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.97
|
| Rate for Payer: Healthscope Commercial |
$197.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$186.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.97
|
| Rate for Payer: PHP Commercial |
$186.97
|
| Rate for Payer: Priority Health SBD |
$138.57
|
| Rate for Payer: UMR Bronson Commercial |
$96.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.97
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$2.61
|
|
|
Service Code
|
NDC 50268070911
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$2.35 |
| Rate for Payer: Aetna American Axle |
$1.70
|
| Rate for Payer: Aetna Commercial |
$2.22
|
| Rate for Payer: Aetna Medicare |
$1.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.70
|
| Rate for Payer: BCBS Complete |
$1.04
|
| Rate for Payer: Cash Price |
$2.09
|
| Rate for Payer: Cofinity Advantage |
$1.83
|
| Rate for Payer: Cofinity Commercial |
$2.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.09
|
| Rate for Payer: Healthscope Commercial |
$2.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.96
|
| Rate for Payer: PHP Commercial |
$2.22
|
| Rate for Payer: Priority Health SBD |
$1.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.70
|
| Rate for Payer: UHC Core |
$1.36
|
| Rate for Payer: UHC Exchange |
$1.03
|
| Rate for Payer: UMR Bronson Commercial |
$0.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.96
|
|
|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
IP
|
$493.44
|
|
|
Service Code
|
NDC 00904677961
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$217.11 |
| Max. Negotiated Rate |
$444.10 |
| Rate for Payer: Aetna American Axle |
$320.74
|
| Rate for Payer: Aetna Commercial |
$419.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Cash Price |
$394.75
|
| Rate for Payer: Cofinity Advantage |
$345.41
|
| Rate for Payer: Cofinity Commercial |
$424.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$394.75
|
| Rate for Payer: Healthscope Commercial |
$444.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$345.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$419.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.08
|
| Rate for Payer: PHP Commercial |
$419.42
|
| Rate for Payer: Priority Health SBD |
$310.87
|
| Rate for Payer: UMR Bronson Commercial |
$217.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.08
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$133.25
|
|
|
Service Code
|
NDC 72205000490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.63 |
| Max. Negotiated Rate |
$119.92 |
| Rate for Payer: Aetna American Axle |
$86.61
|
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.61
|
| Rate for Payer: Cash Price |
$106.60
|
| Rate for Payer: Cofinity Advantage |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$114.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.60
|
| Rate for Payer: Healthscope Commercial |
$119.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.94
|
| Rate for Payer: PHP Commercial |
$113.26
|
| Rate for Payer: Priority Health SBD |
$83.95
|
| Rate for Payer: UMR Bronson Commercial |
$58.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.94
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$133.25
|
|
|
Service Code
|
NDC 72205000490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.30 |
| Max. Negotiated Rate |
$119.92 |
| Rate for Payer: Aetna American Axle |
$86.61
|
| Rate for Payer: Aetna Commercial |
$113.26
|
| Rate for Payer: Aetna Medicare |
$66.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.61
|
| Rate for Payer: BCBS Complete |
$53.30
|
| Rate for Payer: Cash Price |
$106.60
|
| Rate for Payer: Cofinity Advantage |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$114.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.60
|
| Rate for Payer: Healthscope Commercial |
$119.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$106.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.94
|
| Rate for Payer: PHP Commercial |
$113.26
|
| Rate for Payer: Priority Health SBD |
$83.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.61
|
| Rate for Payer: UHC Core |
$69.42
|
| Rate for Payer: UHC Exchange |
$52.37
|
| Rate for Payer: UMR Bronson Commercial |
$49.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.94
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$157.68
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$69.38 |
| Max. Negotiated Rate |
$141.91 |
| Rate for Payer: Aetna American Axle |
$102.49
|
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.49
|
| Rate for Payer: Cash Price |
$126.14
|
| Rate for Payer: Cofinity Advantage |
$110.38
|
| Rate for Payer: Cofinity Commercial |
$135.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.14
|
| Rate for Payer: Healthscope Commercial |
$141.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.26
|
| Rate for Payer: PHP Commercial |
$134.03
|
| Rate for Payer: Priority Health SBD |
$99.34
|
| Rate for Payer: UMR Bronson Commercial |
$69.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.26
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$157.68
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$141.91 |
| Rate for Payer: Aetna American Axle |
$102.49
|
| Rate for Payer: Aetna Commercial |
$134.03
|
| Rate for Payer: Aetna Medicare |
$78.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.49
|
| Rate for Payer: BCBS Complete |
$63.07
|
| Rate for Payer: Cash Price |
$126.14
|
| Rate for Payer: Cofinity Advantage |
$110.38
|
| Rate for Payer: Cofinity Commercial |
$135.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.14
|
| Rate for Payer: Healthscope Commercial |
$141.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.26
|
| Rate for Payer: PHP Commercial |
$134.03
|
| Rate for Payer: Priority Health SBD |
$99.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.49
|
| Rate for Payer: UHC Core |
$82.15
|
| Rate for Payer: UHC Exchange |
$61.97
|
| Rate for Payer: UMR Bronson Commercial |
$58.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.26
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$101.52
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$37.56 |
| Max. Negotiated Rate |
$91.37 |
| Rate for Payer: Aetna American Axle |
$65.99
|
| Rate for Payer: Aetna Commercial |
$86.29
|
| Rate for Payer: Aetna Medicare |
$50.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.99
|
| Rate for Payer: BCBS Complete |
$40.61
|
| Rate for Payer: Cash Price |
$81.22
|
| Rate for Payer: Cofinity Advantage |
$71.06
|
| Rate for Payer: Cofinity Commercial |
$87.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.22
|
| Rate for Payer: Healthscope Commercial |
$91.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.14
|
| Rate for Payer: PHP Commercial |
$86.29
|
| Rate for Payer: Priority Health SBD |
$63.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.99
|
| Rate for Payer: UHC Core |
$52.89
|
| Rate for Payer: UHC Exchange |
$39.90
|
| Rate for Payer: UMR Bronson Commercial |
$37.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.14
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$217.85
|
|
|
Service Code
|
NDC 70377000812
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna Medicare |
$108.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: BCBS Complete |
$87.14
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.60
|
| Rate for Payer: UHC Core |
$113.50
|
| Rate for Payer: UHC Exchange |
$85.62
|
| Rate for Payer: UMR Bronson Commercial |
$80.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$217.85
|
|
|
Service Code
|
NDC 27808015701
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna Medicare |
$108.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: BCBS Complete |
$87.14
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.60
|
| Rate for Payer: UHC Core |
$113.50
|
| Rate for Payer: UHC Exchange |
$85.62
|
| Rate for Payer: UMR Bronson Commercial |
$80.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$175.55
|
|
|
Service Code
|
NDC 31722088490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$77.24 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Advantage |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$158.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.66
|
| Rate for Payer: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$77.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$217.85
|
|
|
Service Code
|
NDC 67877044190
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.60 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna Medicare |
$108.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: BCBS Complete |
$87.14
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.60
|
| Rate for Payer: UHC Core |
$113.50
|
| Rate for Payer: UHC Exchange |
$85.62
|
| Rate for Payer: UMR Bronson Commercial |
$80.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$217.85
|
|
|
Service Code
|
NDC 70377000812
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UMR Bronson Commercial |
$95.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$3.16
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.84 |
| Rate for Payer: Aetna American Axle |
$2.05
|
| Rate for Payer: Aetna Commercial |
$2.69
|
| Rate for Payer: Aetna Medicare |
$1.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.05
|
| Rate for Payer: BCBS Complete |
$1.26
|
| Rate for Payer: Cash Price |
$2.53
|
| Rate for Payer: Cofinity Advantage |
$2.21
|
| Rate for Payer: Cofinity Commercial |
$2.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.53
|
| Rate for Payer: Healthscope Commercial |
$2.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.37
|
| Rate for Payer: PHP Commercial |
$2.69
|
| Rate for Payer: Priority Health SBD |
$1.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.05
|
| Rate for Payer: UHC Core |
$1.65
|
| Rate for Payer: UHC Exchange |
$1.24
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.37
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$217.85
|
|
|
Service Code
|
NDC 27808015701
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UMR Bronson Commercial |
$95.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$449.76
|
|
|
Service Code
|
NDC 00904678061
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$166.41 |
| Max. Negotiated Rate |
$404.78 |
| Rate for Payer: Aetna American Axle |
$292.34
|
| Rate for Payer: Aetna Commercial |
$382.30
|
| Rate for Payer: Aetna Medicare |
$224.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.34
|
| Rate for Payer: BCBS Complete |
$179.90
|
| Rate for Payer: Cash Price |
$359.81
|
| Rate for Payer: Cofinity Advantage |
$314.83
|
| Rate for Payer: Cofinity Commercial |
$386.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.81
|
| Rate for Payer: Healthscope Commercial |
$404.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$359.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.32
|
| Rate for Payer: PHP Commercial |
$382.30
|
| Rate for Payer: Priority Health SBD |
$283.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.34
|
| Rate for Payer: UHC Core |
$234.32
|
| Rate for Payer: UHC Exchange |
$176.76
|
| Rate for Payer: UMR Bronson Commercial |
$166.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.32
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$449.76
|
|
|
Service Code
|
NDC 00904678061
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$197.89 |
| Max. Negotiated Rate |
$404.78 |
| Rate for Payer: Aetna American Axle |
$292.34
|
| Rate for Payer: Aetna Commercial |
$382.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.34
|
| Rate for Payer: Cash Price |
$359.81
|
| Rate for Payer: Cofinity Advantage |
$314.83
|
| Rate for Payer: Cofinity Commercial |
$386.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$359.81
|
| Rate for Payer: Healthscope Commercial |
$404.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$314.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.32
|
| Rate for Payer: PHP Commercial |
$382.30
|
| Rate for Payer: Priority Health SBD |
$283.35
|
| Rate for Payer: UMR Bronson Commercial |
$197.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.32
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$101.52
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$44.67 |
| Max. Negotiated Rate |
$91.37 |
| Rate for Payer: Aetna American Axle |
$65.99
|
| Rate for Payer: Aetna Commercial |
$86.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.99
|
| Rate for Payer: Cash Price |
$81.22
|
| Rate for Payer: Cofinity Advantage |
$71.06
|
| Rate for Payer: Cofinity Commercial |
$87.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.22
|
| Rate for Payer: Healthscope Commercial |
$91.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.14
|
| Rate for Payer: PHP Commercial |
$86.29
|
| Rate for Payer: Priority Health SBD |
$63.96
|
| Rate for Payer: UMR Bronson Commercial |
$44.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.14
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$3.16
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$2.84 |
| Rate for Payer: Aetna American Axle |
$2.05
|
| Rate for Payer: Aetna Commercial |
$2.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.05
|
| Rate for Payer: Cash Price |
$2.53
|
| Rate for Payer: Cofinity Advantage |
$2.21
|
| Rate for Payer: Cofinity Commercial |
$2.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.53
|
| Rate for Payer: Healthscope Commercial |
$2.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.37
|
| Rate for Payer: PHP Commercial |
$2.69
|
| Rate for Payer: Priority Health SBD |
$1.99
|
| Rate for Payer: UMR Bronson Commercial |
$1.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.37
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$217.85
|
|
|
Service Code
|
NDC 67877044190
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$95.85 |
| Max. Negotiated Rate |
$196.06 |
| Rate for Payer: Aetna American Axle |
$141.60
|
| Rate for Payer: Aetna Commercial |
$185.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.60
|
| Rate for Payer: Cash Price |
$174.28
|
| Rate for Payer: Cofinity Advantage |
$152.50
|
| Rate for Payer: Cofinity Commercial |
$187.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.28
|
| Rate for Payer: Healthscope Commercial |
$196.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.39
|
| Rate for Payer: PHP Commercial |
$185.17
|
| Rate for Payer: Priority Health SBD |
$137.25
|
| Rate for Payer: UMR Bronson Commercial |
$95.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.39
|
|
