|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$225.15
|
|
|
Service Code
|
NDC 00904629161
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.07 |
| Max. Negotiated Rate |
$202.63 |
| Rate for Payer: Aetna American Axle |
$146.35
|
| Rate for Payer: Aetna Commercial |
$191.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.35
|
| Rate for Payer: Cash Price |
$180.12
|
| Rate for Payer: Cofinity Advantage |
$157.60
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$157.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.86
|
| Rate for Payer: PHP Commercial |
$191.38
|
| Rate for Payer: Priority Health SBD |
$141.84
|
| Rate for Payer: UMR Bronson Commercial |
$99.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.86
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$313.02
|
|
|
Service Code
|
NDC 63304082890
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$137.73 |
| Max. Negotiated Rate |
$281.72 |
| Rate for Payer: Aetna American Axle |
$203.46
|
| Rate for Payer: Aetna Commercial |
$266.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.46
|
| Rate for Payer: Cash Price |
$250.42
|
| Rate for Payer: Cofinity Advantage |
$219.11
|
| Rate for Payer: Cofinity Commercial |
$269.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.42
|
| Rate for Payer: Healthscope Commercial |
$281.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.76
|
| Rate for Payer: PHP Commercial |
$266.07
|
| Rate for Payer: Priority Health SBD |
$197.20
|
| Rate for Payer: UMR Bronson Commercial |
$137.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.76
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$313.02
|
|
|
Service Code
|
NDC 63304082890
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$115.82 |
| Max. Negotiated Rate |
$281.72 |
| Rate for Payer: Aetna American Axle |
$203.46
|
| Rate for Payer: Aetna Commercial |
$266.07
|
| Rate for Payer: Aetna Medicare |
$156.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.46
|
| Rate for Payer: BCBS Complete |
$125.21
|
| Rate for Payer: Cash Price |
$250.42
|
| Rate for Payer: Cofinity Advantage |
$219.11
|
| Rate for Payer: Cofinity Commercial |
$269.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$250.42
|
| Rate for Payer: Healthscope Commercial |
$281.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$219.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.76
|
| Rate for Payer: PHP Commercial |
$266.07
|
| Rate for Payer: Priority Health SBD |
$197.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.46
|
| Rate for Payer: UHC Core |
$163.08
|
| Rate for Payer: UHC Exchange |
$123.02
|
| Rate for Payer: UMR Bronson Commercial |
$115.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.76
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
OP
|
$5,963.29
|
|
|
Service Code
|
NDC 00071015640
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,206.42 |
| Max. Negotiated Rate |
$5,366.96 |
| Rate for Payer: Aetna American Axle |
$3,876.14
|
| Rate for Payer: Aetna Commercial |
$5,068.80
|
| Rate for Payer: Aetna Medicare |
$2,981.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,876.14
|
| Rate for Payer: BCBS Complete |
$2,385.32
|
| Rate for Payer: Cash Price |
$4,770.63
|
| Rate for Payer: Cofinity Advantage |
$4,174.30
|
| Rate for Payer: Cofinity Commercial |
$5,128.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,770.63
|
| Rate for Payer: Healthscope Commercial |
$5,366.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,174.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,472.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,770.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,068.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,472.47
|
| Rate for Payer: PHP Commercial |
$5,068.80
|
| Rate for Payer: Priority Health SBD |
$3,756.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,876.14
|
| Rate for Payer: UHC Core |
$3,106.87
|
| Rate for Payer: UHC Exchange |
$2,343.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,206.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,472.47
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$5,963.29
|
|
|
Service Code
|
NDC 00071015640
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,623.85 |
| Max. Negotiated Rate |
$5,366.96 |
| Rate for Payer: Aetna American Axle |
$3,876.14
|
| Rate for Payer: Aetna Commercial |
$5,068.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,876.14
|
| Rate for Payer: Cash Price |
$4,770.63
|
| Rate for Payer: Cofinity Advantage |
$4,174.30
|
| Rate for Payer: Cofinity Commercial |
$5,128.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,770.63
|
| Rate for Payer: Healthscope Commercial |
$5,366.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,174.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,472.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,068.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,472.47
|
| Rate for Payer: PHP Commercial |
$5,068.80
|
| Rate for Payer: Priority Health SBD |
$3,756.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,623.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,472.47
|
|
|
ATORVASTATIN 20 MG TABLET
|
Facility
|
IP
|
$247.95
|
|
|
Service Code
|
NDC 68084009801
|
| Hospital Charge Code |
19178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$109.10 |
| Max. Negotiated Rate |
$223.16 |
| Rate for Payer: Aetna American Axle |
$161.17
|
| Rate for Payer: Aetna Commercial |
$210.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.17
|
| Rate for Payer: Cash Price |
$198.36
|
| Rate for Payer: Cofinity Advantage |
$173.56
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$173.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.96
|
| Rate for Payer: PHP Commercial |
$210.76
|
| Rate for Payer: Priority Health SBD |
$156.21
|
| Rate for Payer: UMR Bronson Commercial |
$109.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.96
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$304.56
|
|
|
Service Code
|
NDC 00378395277
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$134.01 |
| Max. Negotiated Rate |
$274.10 |
| Rate for Payer: Aetna American Axle |
$197.96
|
| Rate for Payer: Aetna Commercial |
$258.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.96
|
| Rate for Payer: Cash Price |
$243.65
|
| Rate for Payer: Cofinity Advantage |
$213.19
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.65
|
| Rate for Payer: Healthscope Commercial |
$274.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.42
|
| Rate for Payer: PHP Commercial |
$258.88
|
| Rate for Payer: Priority Health SBD |
$191.87
|
| Rate for Payer: UMR Bronson Commercial |
$134.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.42
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$226.10
|
|
|
Service Code
|
NDC 00904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.48 |
| Max. Negotiated Rate |
$203.49 |
| Rate for Payer: Aetna American Axle |
$146.97
|
| Rate for Payer: Aetna Commercial |
$192.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.97
|
| Rate for Payer: Cash Price |
$180.88
|
| Rate for Payer: Cofinity Advantage |
$158.27
|
| Rate for Payer: Cofinity Commercial |
$194.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.88
|
| Rate for Payer: Healthscope Commercial |
$203.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: PHP Commercial |
$192.19
|
| Rate for Payer: Priority Health SBD |
$142.44
|
| Rate for Payer: UMR Bronson Commercial |
$99.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.57
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$304.56
|
|
|
Service Code
|
NDC 00378395277
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$112.69 |
| Max. Negotiated Rate |
$274.10 |
| Rate for Payer: Aetna American Axle |
$197.96
|
| Rate for Payer: Aetna Commercial |
$258.88
|
| Rate for Payer: Aetna Medicare |
$152.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.96
|
| Rate for Payer: BCBS Complete |
$121.82
|
| Rate for Payer: Cash Price |
$243.65
|
| Rate for Payer: Cofinity Advantage |
$213.19
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.65
|
| Rate for Payer: Healthscope Commercial |
$274.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$258.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.42
|
| Rate for Payer: PHP Commercial |
$258.88
|
| Rate for Payer: Priority Health SBD |
$191.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.96
|
| Rate for Payer: UHC Core |
$158.68
|
| Rate for Payer: UHC Exchange |
$119.69
|
| Rate for Payer: UMR Bronson Commercial |
$112.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.42
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$191.52
|
|
|
Service Code
|
NDC 60505258009
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$84.27 |
| Max. Negotiated Rate |
$172.37 |
| Rate for Payer: Aetna American Axle |
$124.49
|
| Rate for Payer: Aetna Commercial |
$162.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.49
|
| Rate for Payer: Cash Price |
$153.22
|
| Rate for Payer: Cofinity Advantage |
$134.06
|
| Rate for Payer: Cofinity Commercial |
$164.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.22
|
| Rate for Payer: Healthscope Commercial |
$172.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.64
|
| Rate for Payer: PHP Commercial |
$162.79
|
| Rate for Payer: Priority Health SBD |
$120.66
|
| Rate for Payer: UMR Bronson Commercial |
$84.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.64
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$3.47 |
| Rate for Payer: Aetna American Axle |
$2.51
|
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.51
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$2.70
|
| Rate for Payer: Cofinity Commercial |
$3.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.28
|
| Rate for Payer: Priority Health SBD |
$2.43
|
| Rate for Payer: UMR Bronson Commercial |
$1.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.90
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$365.90
|
|
|
Service Code
|
NDC 63304082990
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$329.31 |
| Rate for Payer: Aetna American Axle |
$237.84
|
| Rate for Payer: Aetna Commercial |
$311.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.84
|
| Rate for Payer: Cash Price |
$292.72
|
| Rate for Payer: Cofinity Advantage |
$256.13
|
| Rate for Payer: Cofinity Commercial |
$314.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.72
|
| Rate for Payer: Healthscope Commercial |
$329.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.43
|
| Rate for Payer: PHP Commercial |
$311.01
|
| Rate for Payer: Priority Health SBD |
$230.52
|
| Rate for Payer: UMR Bronson Commercial |
$161.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.43
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$191.52
|
|
|
Service Code
|
NDC 60505258009
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$70.86 |
| Max. Negotiated Rate |
$172.37 |
| Rate for Payer: Aetna American Axle |
$124.49
|
| Rate for Payer: Aetna Commercial |
$162.79
|
| Rate for Payer: Aetna Medicare |
$95.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.49
|
| Rate for Payer: BCBS Complete |
$76.61
|
| Rate for Payer: Cash Price |
$153.22
|
| Rate for Payer: Cofinity Advantage |
$134.06
|
| Rate for Payer: Cofinity Commercial |
$164.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.22
|
| Rate for Payer: Healthscope Commercial |
$172.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$162.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.64
|
| Rate for Payer: PHP Commercial |
$162.79
|
| Rate for Payer: Priority Health SBD |
$120.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.49
|
| Rate for Payer: UHC Core |
$99.78
|
| Rate for Payer: UHC Exchange |
$75.27
|
| Rate for Payer: UMR Bronson Commercial |
$70.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.64
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$385.70
|
|
|
Service Code
|
NDC 51079021020
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$142.71 |
| Max. Negotiated Rate |
$347.13 |
| Rate for Payer: Aetna American Axle |
$250.71
|
| Rate for Payer: Aetna Commercial |
$327.85
|
| Rate for Payer: Aetna Medicare |
$192.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.71
|
| Rate for Payer: BCBS Complete |
$154.28
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Advantage |
$269.99
|
| Rate for Payer: Cofinity Commercial |
$331.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$347.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.27
|
| Rate for Payer: PHP Commercial |
$327.85
|
| Rate for Payer: Priority Health SBD |
$242.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.71
|
| Rate for Payer: UHC Core |
$200.95
|
| Rate for Payer: UHC Exchange |
$151.58
|
| Rate for Payer: UMR Bronson Commercial |
$142.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.27
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$1,492.25
|
|
|
Service Code
|
NDC 55111012305
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$656.59 |
| Max. Negotiated Rate |
$1,343.03 |
| Rate for Payer: Aetna American Axle |
$969.96
|
| Rate for Payer: Aetna Commercial |
$1,268.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.96
|
| Rate for Payer: Cash Price |
$1,193.80
|
| Rate for Payer: Cofinity Advantage |
$1,044.58
|
| Rate for Payer: Cofinity Commercial |
$1,283.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.80
|
| Rate for Payer: Healthscope Commercial |
$1,343.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.19
|
| Rate for Payer: PHP Commercial |
$1,268.41
|
| Rate for Payer: Priority Health SBD |
$940.12
|
| Rate for Payer: UMR Bronson Commercial |
$656.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.19
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$105.75
|
|
|
Service Code
|
NDC 43598010190
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$46.53 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UMR Bronson Commercial |
$46.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$6,359.56
|
|
|
Service Code
|
NDC 00071015740
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,798.21 |
| Max. Negotiated Rate |
$5,723.60 |
| Rate for Payer: Aetna American Axle |
$4,133.71
|
| Rate for Payer: Aetna Commercial |
$5,405.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,133.71
|
| Rate for Payer: Cash Price |
$5,087.65
|
| Rate for Payer: Cofinity Advantage |
$4,451.69
|
| Rate for Payer: Cofinity Commercial |
$5,469.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.65
|
| Rate for Payer: Healthscope Commercial |
$5,723.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,451.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,405.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,769.67
|
| Rate for Payer: PHP Commercial |
$5,405.63
|
| Rate for Payer: Priority Health SBD |
$4,006.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,798.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.67
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$365.90
|
|
|
Service Code
|
NDC 63304082990
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$135.38 |
| Max. Negotiated Rate |
$329.31 |
| Rate for Payer: Aetna American Axle |
$237.84
|
| Rate for Payer: Aetna Commercial |
$311.01
|
| Rate for Payer: Aetna Medicare |
$182.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.84
|
| Rate for Payer: BCBS Complete |
$146.36
|
| Rate for Payer: Cash Price |
$292.72
|
| Rate for Payer: Cofinity Advantage |
$256.13
|
| Rate for Payer: Cofinity Commercial |
$314.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.72
|
| Rate for Payer: Healthscope Commercial |
$329.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$256.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.43
|
| Rate for Payer: PHP Commercial |
$311.01
|
| Rate for Payer: Priority Health SBD |
$230.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$237.84
|
| Rate for Payer: UHC Core |
$190.63
|
| Rate for Payer: UHC Exchange |
$143.80
|
| Rate for Payer: UMR Bronson Commercial |
$135.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.43
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$1,492.25
|
|
|
Service Code
|
NDC 55111012305
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$552.13 |
| Max. Negotiated Rate |
$1,343.03 |
| Rate for Payer: Aetna American Axle |
$969.96
|
| Rate for Payer: Aetna Commercial |
$1,268.41
|
| Rate for Payer: Aetna Medicare |
$746.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$969.96
|
| Rate for Payer: BCBS Complete |
$596.90
|
| Rate for Payer: Cash Price |
$1,193.80
|
| Rate for Payer: Cofinity Advantage |
$1,044.58
|
| Rate for Payer: Cofinity Commercial |
$1,283.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,193.80
|
| Rate for Payer: Healthscope Commercial |
$1,343.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,044.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,119.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,193.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,268.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,119.19
|
| Rate for Payer: PHP Commercial |
$1,268.41
|
| Rate for Payer: Priority Health SBD |
$940.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$969.96
|
| Rate for Payer: UHC Core |
$777.46
|
| Rate for Payer: UHC Exchange |
$586.45
|
| Rate for Payer: UMR Bronson Commercial |
$552.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,119.19
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$105.75
|
|
|
Service Code
|
NDC 43598010190
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$39.13 |
| Max. Negotiated Rate |
$95.17 |
| Rate for Payer: Aetna American Axle |
$68.74
|
| Rate for Payer: Aetna Commercial |
$89.89
|
| Rate for Payer: Aetna Medicare |
$52.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.74
|
| Rate for Payer: BCBS Complete |
$42.30
|
| Rate for Payer: Cash Price |
$84.60
|
| Rate for Payer: Cofinity Advantage |
$74.03
|
| Rate for Payer: Cofinity Commercial |
$90.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.60
|
| Rate for Payer: Healthscope Commercial |
$95.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.31
|
| Rate for Payer: PHP Commercial |
$89.89
|
| Rate for Payer: Priority Health SBD |
$66.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.74
|
| Rate for Payer: UHC Core |
$55.10
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UMR Bronson Commercial |
$39.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.31
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$6,359.56
|
|
|
Service Code
|
NDC 00071015740
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2,353.04 |
| Max. Negotiated Rate |
$5,723.60 |
| Rate for Payer: Aetna American Axle |
$4,133.71
|
| Rate for Payer: Aetna Commercial |
$5,405.63
|
| Rate for Payer: Aetna Medicare |
$3,179.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,133.71
|
| Rate for Payer: BCBS Complete |
$2,543.82
|
| Rate for Payer: Cash Price |
$5,087.65
|
| Rate for Payer: Cofinity Advantage |
$4,451.69
|
| Rate for Payer: Cofinity Commercial |
$5,469.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,087.65
|
| Rate for Payer: Healthscope Commercial |
$5,723.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,451.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,769.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,087.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,405.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,769.67
|
| Rate for Payer: PHP Commercial |
$5,405.63
|
| Rate for Payer: Priority Health SBD |
$4,006.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,133.71
|
| Rate for Payer: UHC Core |
$3,313.33
|
| Rate for Payer: UHC Exchange |
$2,499.31
|
| Rate for Payer: UMR Bronson Commercial |
$2,353.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,769.67
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$3.86
|
|
|
Service Code
|
NDC 51079021001
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$3.47 |
| Rate for Payer: Aetna American Axle |
$2.51
|
| Rate for Payer: Aetna Commercial |
$3.28
|
| Rate for Payer: Aetna Medicare |
$1.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.51
|
| Rate for Payer: BCBS Complete |
$1.54
|
| Rate for Payer: Cash Price |
$3.09
|
| Rate for Payer: Cofinity Advantage |
$2.70
|
| Rate for Payer: Cofinity Commercial |
$3.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.09
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2.90
|
| Rate for Payer: PHP Commercial |
$3.28
|
| Rate for Payer: Priority Health SBD |
$2.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.51
|
| Rate for Payer: UHC Core |
$2.01
|
| Rate for Payer: UHC Exchange |
$1.52
|
| Rate for Payer: UMR Bronson Commercial |
$1.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.90
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
OP
|
$226.10
|
|
|
Service Code
|
NDC 00904629261
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$83.66 |
| Max. Negotiated Rate |
$203.49 |
| Rate for Payer: Aetna American Axle |
$146.97
|
| Rate for Payer: Aetna Commercial |
$192.19
|
| Rate for Payer: Aetna Medicare |
$113.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.97
|
| Rate for Payer: BCBS Complete |
$90.44
|
| Rate for Payer: Cash Price |
$180.88
|
| Rate for Payer: Cofinity Advantage |
$158.27
|
| Rate for Payer: Cofinity Commercial |
$194.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.88
|
| Rate for Payer: Healthscope Commercial |
$203.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.57
|
| Rate for Payer: PHP Commercial |
$192.19
|
| Rate for Payer: Priority Health SBD |
$142.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.97
|
| Rate for Payer: UHC Core |
$117.80
|
| Rate for Payer: UHC Exchange |
$88.86
|
| Rate for Payer: UMR Bronson Commercial |
$83.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.57
|
|
|
ATORVASTATIN 40 MG TABLET
|
Facility
|
IP
|
$385.70
|
|
|
Service Code
|
NDC 51079021020
|
| Hospital Charge Code |
19177
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.71 |
| Max. Negotiated Rate |
$347.13 |
| Rate for Payer: Aetna American Axle |
$250.71
|
| Rate for Payer: Aetna Commercial |
$327.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.71
|
| Rate for Payer: Cash Price |
$308.56
|
| Rate for Payer: Cofinity Advantage |
$269.99
|
| Rate for Payer: Cofinity Commercial |
$331.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.56
|
| Rate for Payer: Healthscope Commercial |
$347.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.27
|
| Rate for Payer: PHP Commercial |
$327.85
|
| Rate for Payer: Priority Health SBD |
$242.99
|
| Rate for Payer: UMR Bronson Commercial |
$169.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.27
|
|
|
ATORVASTATIN 80 MG TABLET
|
Facility
|
OP
|
$74.31
|
|
|
Service Code
|
NDC 51079021103
|
| Hospital Charge Code |
28645
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$27.49 |
| Max. Negotiated Rate |
$66.88 |
| Rate for Payer: Aetna American Axle |
$48.30
|
| Rate for Payer: Aetna Commercial |
$63.16
|
| Rate for Payer: Aetna Medicare |
$37.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.30
|
| Rate for Payer: BCBS Complete |
$29.72
|
| Rate for Payer: Cash Price |
$59.45
|
| Rate for Payer: Cofinity Advantage |
$52.02
|
| Rate for Payer: Cofinity Commercial |
$63.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.45
|
| Rate for Payer: Healthscope Commercial |
$66.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.73
|
| Rate for Payer: PHP Commercial |
$63.16
|
| Rate for Payer: Priority Health SBD |
$46.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.30
|
| Rate for Payer: UHC Core |
$38.72
|
| Rate for Payer: UHC Exchange |
$29.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.73
|
|
