|
ROSUVASTATIN 10 MG TABLET
|
Facility
|
OP
|
$175.55
|
|
|
Service Code
|
NDC 31722088390
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna Medicare |
$87.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.89
|
| 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: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$64.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
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 Commercial |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.89
|
| 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: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| 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
|
IP
|
$5.42
|
|
|
Service Code
|
NDC 60687024511
|
| Hospital Charge Code |
35134
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$4.88 |
| Rate for Payer: Aetna American Axle |
$3.52
|
| Rate for Payer: Aetna Commercial |
$4.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.52
|
| Rate for Payer: Cash Price |
$4.34
|
| Rate for Payer: Cofinity Commercial |
$3.79
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.34
|
| Rate for Payer: Healthscope Commercial |
$4.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.61
|
| Rate for Payer: PHP Commercial |
$4.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.52
|
| Rate for Payer: Priority Health SBD |
$3.41
|
| Rate for Payer: UMR Bronson Commercial |
$2.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.07
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$2,862.47
|
|
|
Service Code
|
NDC 00310075290
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,059.11 |
| Max. Negotiated Rate |
$2,576.22 |
| Rate for Payer: Aetna American Axle |
$1,860.61
|
| Rate for Payer: Aetna Commercial |
$2,433.10
|
| Rate for Payer: Aetna Medicare |
$1,431.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,860.61
|
| Rate for Payer: BCBS Complete |
$1,144.99
|
| Rate for Payer: Cash Price |
$2,289.98
|
| Rate for Payer: Cofinity Commercial |
$2,003.73
|
| Rate for Payer: Cofinity Commercial |
$2,461.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,003.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.98
|
| Rate for Payer: Healthscope Commercial |
$2,576.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,003.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,433.10
|
| Rate for Payer: PHP Commercial |
$2,433.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,860.61
|
| Rate for Payer: Priority Health SBD |
$1,803.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,059.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.85
|
|
|
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 Commercial |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.89
|
| 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: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| 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
|
$175.55
|
|
|
Service Code
|
NDC 31722088490
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$64.95 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: Aetna American Axle |
$114.11
|
| Rate for Payer: Aetna Commercial |
$149.22
|
| Rate for Payer: Aetna Medicare |
$87.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.11
|
| Rate for Payer: BCBS Complete |
$70.22
|
| Rate for Payer: Cash Price |
$140.44
|
| Rate for Payer: Cofinity Commercial |
$122.89
|
| Rate for Payer: Cofinity Commercial |
$150.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$122.89
|
| 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: PHP Commercial |
$149.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.11
|
| Rate for Payer: Priority Health SBD |
$110.60
|
| Rate for Payer: UMR Bronson Commercial |
$64.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.66
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$224.19
|
|
|
Service Code
|
NDC 27808015701
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.64 |
| Max. Negotiated Rate |
$201.77 |
| Rate for Payer: Aetna American Axle |
$145.72
|
| Rate for Payer: Aetna Commercial |
$190.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.72
|
| Rate for Payer: Cash Price |
$179.35
|
| Rate for Payer: Cofinity Commercial |
$156.93
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.35
|
| Rate for Payer: Healthscope Commercial |
$201.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.56
|
| Rate for Payer: PHP Commercial |
$190.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.72
|
| Rate for Payer: Priority Health SBD |
$141.24
|
| Rate for Payer: UMR Bronson Commercial |
$98.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.14
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$241.11
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$89.21 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Aetna American Axle |
$156.72
|
| Rate for Payer: Aetna Commercial |
$204.94
|
| Rate for Payer: Aetna Medicare |
$120.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.72
|
| Rate for Payer: BCBS Complete |
$96.44
|
| Rate for Payer: Cash Price |
$192.89
|
| Rate for Payer: Cofinity Commercial |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$207.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$168.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.89
|
| Rate for Payer: Healthscope Commercial |
$217.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.94
|
| Rate for Payer: PHP Commercial |
$204.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.72
|
| Rate for Payer: Priority Health SBD |
$151.90
|
| Rate for Payer: UMR Bronson Commercial |
$89.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.83
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$241.11
|
|
|
Service Code
|
NDC 68462026390
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$106.09 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Aetna American Axle |
$156.72
|
| Rate for Payer: Aetna Commercial |
$204.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.72
|
| Rate for Payer: Cash Price |
$192.89
|
| Rate for Payer: Cofinity Commercial |
$168.78
|
| Rate for Payer: Cofinity Commercial |
$207.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$168.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.89
|
| Rate for Payer: Healthscope Commercial |
$217.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.94
|
| Rate for Payer: PHP Commercial |
$204.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.72
|
| Rate for Payer: Priority Health SBD |
$151.90
|
| Rate for Payer: UMR Bronson Commercial |
$106.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.83
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$222.30
|
|
|
Service Code
|
NDC 00781540292
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.25 |
| Max. Negotiated Rate |
$200.07 |
| Rate for Payer: Aetna American Axle |
$144.50
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$155.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.72
|
| 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
|
| Rate for Payer: UMR Bronson Commercial |
$82.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.72
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$222.30
|
|
|
Service Code
|
NDC 00781540292
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$97.81 |
| Max. Negotiated Rate |
$200.07 |
| Rate for Payer: Aetna American Axle |
$144.50
|
| Rate for Payer: Aetna Commercial |
$188.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.50
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$155.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$166.72
|
| 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
|
| Rate for Payer: UMR Bronson Commercial |
$97.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$166.72
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$153.84
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$67.69 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna American Axle |
$100.00
|
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.00
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cofinity Commercial |
$107.69
|
| Rate for Payer: Cofinity Commercial |
$132.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.07
|
| Rate for Payer: Healthscope Commercial |
$138.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.76
|
| Rate for Payer: PHP Commercial |
$130.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.00
|
| Rate for Payer: Priority Health SBD |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$67.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.38
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$2,862.47
|
|
|
Service Code
|
NDC 00310075290
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1,259.49 |
| Max. Negotiated Rate |
$2,576.22 |
| Rate for Payer: Aetna American Axle |
$1,860.61
|
| Rate for Payer: Aetna Commercial |
$2,433.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,860.61
|
| Rate for Payer: Cash Price |
$2,289.98
|
| Rate for Payer: Cofinity Commercial |
$2,003.73
|
| Rate for Payer: Cofinity Commercial |
$2,461.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,003.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,289.98
|
| Rate for Payer: Healthscope Commercial |
$2,576.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,003.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,146.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,433.10
|
| Rate for Payer: PHP Commercial |
$2,433.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,860.61
|
| Rate for Payer: Priority Health SBD |
$1,803.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,259.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,146.85
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$224.19
|
|
|
Service Code
|
NDC 27808015701
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$82.95 |
| Max. Negotiated Rate |
$201.77 |
| Rate for Payer: Aetna American Axle |
$145.72
|
| Rate for Payer: Aetna Commercial |
$190.56
|
| Rate for Payer: Aetna Medicare |
$112.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.72
|
| Rate for Payer: BCBS Complete |
$89.68
|
| Rate for Payer: Cash Price |
$179.35
|
| Rate for Payer: Cofinity Commercial |
$156.93
|
| Rate for Payer: Cofinity Commercial |
$192.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.35
|
| Rate for Payer: Healthscope Commercial |
$201.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.56
|
| Rate for Payer: PHP Commercial |
$190.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.72
|
| Rate for Payer: Priority Health SBD |
$141.24
|
| Rate for Payer: UMR Bronson Commercial |
$82.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.14
|
|
|
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 Commercial |
$314.83
|
| Rate for Payer: Cofinity Commercial |
$386.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$314.83
|
| 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: PHP Commercial |
$382.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.34
|
| Rate for Payer: Priority Health SBD |
$283.35
|
| 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 Commercial |
$314.83
|
| Rate for Payer: Cofinity Commercial |
$386.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$314.83
|
| 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: PHP Commercial |
$382.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.34
|
| 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
|
OP
|
$153.84
|
|
|
Service Code
|
NDC 50268071015
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$56.92 |
| Max. Negotiated Rate |
$138.46 |
| Rate for Payer: Aetna American Axle |
$100.00
|
| Rate for Payer: Aetna Commercial |
$130.76
|
| Rate for Payer: Aetna Medicare |
$76.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.00
|
| Rate for Payer: BCBS Complete |
$61.54
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cofinity Commercial |
$107.69
|
| Rate for Payer: Cofinity Commercial |
$132.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.07
|
| Rate for Payer: Healthscope Commercial |
$138.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.76
|
| Rate for Payer: PHP Commercial |
$130.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.00
|
| Rate for Payer: Priority Health SBD |
$96.92
|
| Rate for Payer: UMR Bronson Commercial |
$56.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.38
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$3.08
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Aetna American Axle |
$2.00
|
| Rate for Payer: Aetna Commercial |
$2.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.00
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.46
|
| Rate for Payer: Healthscope Commercial |
$2.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.62
|
| Rate for Payer: PHP Commercial |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.00
|
| Rate for Payer: Priority Health SBD |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$1.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.31
|
|
|
ROSUVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$3.08
|
|
|
Service Code
|
NDC 50268071011
|
| Hospital Charge Code |
35135
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$2.77 |
| Rate for Payer: Aetna American Axle |
$2.00
|
| Rate for Payer: Aetna Commercial |
$2.62
|
| Rate for Payer: Aetna Medicare |
$1.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.00
|
| Rate for Payer: BCBS Complete |
$1.23
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cofinity Commercial |
$2.16
|
| Rate for Payer: Cofinity Commercial |
$2.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.46
|
| Rate for Payer: Healthscope Commercial |
$2.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.62
|
| Rate for Payer: PHP Commercial |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.00
|
| Rate for Payer: Priority Health SBD |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.31
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.60
|
|
|
Service Code
|
NDC 50268071111
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Aetna American Axle |
$2.34
|
| Rate for Payer: Aetna Commercial |
$3.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.34
|
| Rate for Payer: Cash Price |
$2.88
|
| Rate for Payer: Cofinity Commercial |
$2.52
|
| Rate for Payer: Cofinity Commercial |
$3.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.88
|
| Rate for Payer: Healthscope Commercial |
$3.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.06
|
| Rate for Payer: PHP Commercial |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.34
|
| Rate for Payer: Priority Health SBD |
$2.27
|
| Rate for Payer: UMR Bronson Commercial |
$1.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.70
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.60
|
|
|
Service Code
|
NDC 50268071111
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$3.24 |
| Rate for Payer: Aetna American Axle |
$2.34
|
| Rate for Payer: Aetna Commercial |
$3.06
|
| Rate for Payer: Aetna Medicare |
$1.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.34
|
| Rate for Payer: BCBS Complete |
$1.44
|
| Rate for Payer: Cash Price |
$2.88
|
| Rate for Payer: Cofinity Commercial |
$2.52
|
| Rate for Payer: Cofinity Commercial |
$3.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.88
|
| Rate for Payer: Healthscope Commercial |
$3.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.06
|
| Rate for Payer: PHP Commercial |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.34
|
| Rate for Payer: Priority Health SBD |
$2.27
|
| Rate for Payer: UMR Bronson Commercial |
$1.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.70
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$179.76
|
|
|
Service Code
|
NDC 50268071115
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$79.09 |
| Max. Negotiated Rate |
$161.78 |
| Rate for Payer: Aetna American Axle |
$116.84
|
| Rate for Payer: Aetna Commercial |
$152.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.84
|
| Rate for Payer: Cash Price |
$143.81
|
| Rate for Payer: Cofinity Commercial |
$125.83
|
| Rate for Payer: Cofinity Commercial |
$154.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.81
|
| Rate for Payer: Healthscope Commercial |
$161.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.80
|
| Rate for Payer: PHP Commercial |
$152.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.84
|
| Rate for Payer: Priority Health SBD |
$113.25
|
| Rate for Payer: UMR Bronson Commercial |
$79.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.82
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$179.76
|
|
|
Service Code
|
NDC 50268071115
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$66.51 |
| Max. Negotiated Rate |
$161.78 |
| Rate for Payer: Aetna American Axle |
$116.84
|
| Rate for Payer: Aetna Commercial |
$152.80
|
| Rate for Payer: Aetna Medicare |
$89.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.84
|
| Rate for Payer: BCBS Complete |
$71.90
|
| Rate for Payer: Cash Price |
$143.81
|
| Rate for Payer: Cofinity Commercial |
$125.83
|
| Rate for Payer: Cofinity Commercial |
$154.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$125.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.81
|
| Rate for Payer: Healthscope Commercial |
$161.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.80
|
| Rate for Payer: PHP Commercial |
$152.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.84
|
| Rate for Payer: Priority Health SBD |
$113.25
|
| Rate for Payer: UMR Bronson Commercial |
$66.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.82
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$573.60
|
|
|
Service Code
|
NDC 00904678161
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$212.23 |
| Max. Negotiated Rate |
$516.24 |
| Rate for Payer: Aetna American Axle |
$372.84
|
| Rate for Payer: Aetna Commercial |
$487.56
|
| Rate for Payer: Aetna Medicare |
$286.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.84
|
| Rate for Payer: BCBS Complete |
$229.44
|
| Rate for Payer: Cash Price |
$458.88
|
| Rate for Payer: Cofinity Commercial |
$401.52
|
| Rate for Payer: Cofinity Commercial |
$493.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.88
|
| Rate for Payer: Healthscope Commercial |
$516.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.56
|
| Rate for Payer: PHP Commercial |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.84
|
| Rate for Payer: Priority Health SBD |
$361.37
|
| Rate for Payer: UMR Bronson Commercial |
$212.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.20
|
|
|
ROSUVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$573.60
|
|
|
Service Code
|
NDC 00904678161
|
| Hospital Charge Code |
35136
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$252.38 |
| Max. Negotiated Rate |
$516.24 |
| Rate for Payer: Aetna American Axle |
$372.84
|
| Rate for Payer: Aetna Commercial |
$487.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$372.84
|
| Rate for Payer: Cash Price |
$458.88
|
| Rate for Payer: Cofinity Commercial |
$401.52
|
| Rate for Payer: Cofinity Commercial |
$493.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$401.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$458.88
|
| Rate for Payer: Healthscope Commercial |
$516.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$487.56
|
| Rate for Payer: PHP Commercial |
$487.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$372.84
|
| Rate for Payer: Priority Health SBD |
$361.37
|
| Rate for Payer: UMR Bronson Commercial |
$252.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.20
|
|
