Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

ROPINIROLE 0.5 MG TABLET [21800]

Facility

IP

$0.36

Service Code	NDC 62332-031-31
Hospital Charge Code	1711816
Hospital Revenue Code	259
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.29
Rate for Payer: Cash Price	$0.16
Rate for Payer: Cigna of CA HMO/PPO	$0.29
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.27

ROPINIROLE 1 MG TABLET [21689]

Facility

OP

$0.14

Service Code	NDC 68462-255-01
Hospital Charge Code	1712352
Hospital Revenue Code	259
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.11
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.08
Rate for Payer: Aetna of CA Government/Medicare	$0.08
Rate for Payer: Cash Price	$0.06
Rate for Payer: Health Smart Auto/Commercial	$0.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.08
Rate for Payer: LLUH Dept of Risk Management WC	$0.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.11

ROPINIROLE 1 MG TABLET [21689]

Facility

IP

$0.14

Service Code	NDC 68462-255-01
Hospital Charge Code	1712352
Hospital Revenue Code	259
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.11
Rate for Payer: Cash Price	$0.06
Rate for Payer: Cigna of CA HMO/PPO	$0.11
Rate for Payer: Health Smart Auto/Commercial	$0.08
Rate for Payer: LLUH Dept of Risk Management WC	$0.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.11

ROPINIROLE 1 MG TABLET [21689]

Facility

IP

$0.36

Service Code	NDC 62332-032-31
Hospital Charge Code	1712352
Hospital Revenue Code	259
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.29
Rate for Payer: Cash Price	$0.16
Rate for Payer: Cigna of CA HMO/PPO	$0.29
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.27

ROPINIROLE 1 MG TABLET [21689]

Facility

OP

$0.36

Service Code	NDC 62332-032-31
Hospital Charge Code	1712352
Hospital Revenue Code	259
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.27
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.22
Rate for Payer: Aetna of CA Government/Medicare	$0.22
Rate for Payer: Cash Price	$0.16
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.27

ROPINIROLE 2 MG TABLET [21690]

Facility

IP

$0.14

Service Code	NDC 68462-256-01
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.11
Rate for Payer: Cash Price	$0.06
Rate for Payer: Cigna of CA HMO/PPO	$0.11
Rate for Payer: Health Smart Auto/Commercial	$0.08
Rate for Payer: LLUH Dept of Risk Management WC	$0.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.11

ROPINIROLE 2 MG TABLET [21690]

Facility

OP

$0.60

Service Code	NDC 43547-271-10
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.45
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.36
Rate for Payer: Aetna of CA Government/Medicare	$0.36
Rate for Payer: Cash Price	$0.27
Rate for Payer: Health Smart Auto/Commercial	$0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.36
Rate for Payer: LLUH Dept of Risk Management WC	$0.33
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.45

ROPINIROLE 2 MG TABLET [21690]

Facility

OP

$0.36

Service Code	NDC 62332-033-31
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.27
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.22
Rate for Payer: Aetna of CA Government/Medicare	$0.22
Rate for Payer: Cash Price	$0.16
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.27

ROPINIROLE 2 MG TABLET [21690]

Facility

IP

$0.36

Service Code	NDC 62332-033-31
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$0.29
Rate for Payer: Cash Price	$0.16
Rate for Payer: Cigna of CA HMO/PPO	$0.29
Rate for Payer: Health Smart Auto/Commercial	$0.22
Rate for Payer: LLUH Dept of Risk Management WC	$0.20
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.27

ROPINIROLE 2 MG TABLET [21690]

Facility

IP

$0.60

Service Code	NDC 43547-271-10
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.48
Rate for Payer: Cash Price	$0.27
Rate for Payer: Cigna of CA HMO/PPO	$0.48
Rate for Payer: Health Smart Auto/Commercial	$0.36
Rate for Payer: LLUH Dept of Risk Management WC	$0.33
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.45

ROPINIROLE 2 MG TABLET [21690]

Facility

OP

$0.14

Service Code	NDC 68462-256-01
Hospital Charge Code	1712353
Hospital Revenue Code	259
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.11
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.08
Rate for Payer: Aetna of CA Government/Medicare	$0.08
Rate for Payer: Cash Price	$0.06
Rate for Payer: Health Smart Auto/Commercial	$0.08
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.08
Rate for Payer: LLUH Dept of Risk Management WC	$0.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.11

ROPINIROLE 3 MG TABLET [30699]

Facility

IP

$0.60

Service Code	NDC 43547-272-10
Hospital Charge Code	1712354
Hospital Revenue Code	259
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.48
Rate for Payer: Cash Price	$0.27
Rate for Payer: Cigna of CA HMO/PPO	$0.48
Rate for Payer: Health Smart Auto/Commercial	$0.36
Rate for Payer: LLUH Dept of Risk Management WC	$0.33
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.45

ROPINIROLE 3 MG TABLET [30699]

Facility

OP

$0.60

Service Code	NDC 43547-272-10
Hospital Charge Code	1712354
Hospital Revenue Code	259
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.45
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.36
Rate for Payer: Aetna of CA Government/Medicare	$0.36
Rate for Payer: Cash Price	$0.27
Rate for Payer: Health Smart Auto/Commercial	$0.36
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.36
Rate for Payer: LLUH Dept of Risk Management WC	$0.33
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.45

ROPIVACAINE (NAROPIN) 0.2 % TELEFLEX PUMP INFUSION [4081416]

Facility

OP

$0.46

Service Code	CPT J2795
Hospital Charge Code	NDC4081416
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.35
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.28
Rate for Payer: Aetna of CA Government/Medicare	$0.28
Rate for Payer: Cash Price	$0.21
Rate for Payer: Health Smart Auto/Commercial	$0.28
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.28
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.35

ROPIVACAINE (NAROPIN) 0.2 % TELEFLEX PUMP INFUSION [4081416]

Facility

IP

$0.46

Service Code	CPT J2795
Hospital Charge Code	NDC4081416
Hospital Revenue Code	636
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.37
Rate for Payer: Cash Price	$0.21
Rate for Payer: Cigna of CA HMO/PPO	$0.37
Rate for Payer: Health Smart Auto/Commercial	$0.28
Rate for Payer: LLUH Dept of Risk Management WC	$0.25
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.35

ROPIVACAINE (NAROPIN) 0.5 % ON-Q PUMP INFUSION [4081084]

Facility

OP

$0.73

Service Code	CPT J2795
Hospital Charge Code	ERX4081084
Hospital Revenue Code	636
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.55
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.44
Rate for Payer: Aetna of CA Government/Medicare	$0.44
Rate for Payer: Cash Price	$0.33
Rate for Payer: Health Smart Auto/Commercial	$0.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.44
Rate for Payer: LLUH Dept of Risk Management WC	$0.40
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.55

ROPIVACAINE (NAROPIN) 0.5 % ON-Q PUMP INFUSION [4081084]

Facility

IP

$0.73

Service Code	CPT J2795
Hospital Charge Code	ERX4081084
Hospital Revenue Code	636
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.58
Rate for Payer: Cash Price	$0.33
Rate for Payer: Cigna of CA HMO/PPO	$0.58
Rate for Payer: Health Smart Auto/Commercial	$0.44
Rate for Payer: LLUH Dept of Risk Management WC	$0.40
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.55

ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [18194]

Facility

OP

$1.36

Service Code	CPT J2795
Hospital Charge Code	1722017
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.02
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.82
Rate for Payer: Aetna of CA Government/Medicare	$0.82
Rate for Payer: Cash Price	$0.61
Rate for Payer: Health Smart Auto/Commercial	$0.82
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.82
Rate for Payer: LLUH Dept of Risk Management WC	$0.75
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.02

ROPIVACAINE (PF) 10 MG/ML (1 %) INJECTION SOLUTION [18194]

Facility

IP

$1.36

Service Code	CPT J2795
Hospital Charge Code	1722017
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.09
Rate for Payer: Cash Price	$0.61
Rate for Payer: Cigna of CA HMO/PPO	$1.09
Rate for Payer: Health Smart Auto/Commercial	$0.82
Rate for Payer: LLUH Dept of Risk Management WC	$0.75
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$1.02

ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION [18192]

Facility

OP

$0.49

Service Code	CPT J2795
Hospital Charge Code	1771273
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.37
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.29
Rate for Payer: Aetna of CA Government/Medicare	$0.29
Rate for Payer: Cash Price	$0.22
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION [18192]

Facility

OP

$0.21

Service Code	CPT J2795
Hospital Charge Code	1720981
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.16
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.35
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.35
Rate for Payer: Cash Price	$0.26
Rate for Payer: Cash Price	$0.09
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.35
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.35
Rate for Payer: LLUH Dept of Risk Management WC	$0.32
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.44
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.16

ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION [18192]

Facility

IP

$0.49

Service Code	CPT J2795
Hospital Charge Code	1771273
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.39
Rate for Payer: Cash Price	$0.22
Rate for Payer: Cigna of CA HMO/PPO	$0.39
Rate for Payer: Health Smart Auto/Commercial	$0.29
Rate for Payer: LLUH Dept of Risk Management WC	$0.27
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.37

ROPIVACAINE (PF) 2 MG/ML (0.2 %) INJECTION SOLUTION [18192]

Facility

IP

$0.21

Service Code	CPT J2795
Hospital Charge Code	1720981
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.17
Rate for Payer: Cash Price	$0.09
Rate for Payer: Cash Price	$0.26
Rate for Payer: Cigna of CA HMO/PPO	$0.17
Rate for Payer: Cigna of CA HMO/PPO	$0.46
Rate for Payer: Health Smart Auto/Commercial	$0.35
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.32
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.44
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.16

ROSUVASTATIN 10 MG TABLET [35134]

Facility

IP

$11.06

Service Code	NDC 0310-0751-90
Hospital Charge Code	1712304
Hospital Revenue Code	259
Min. Negotiated Rate	$6.08
Max. Negotiated Rate	$8.85
Rate for Payer: Cash Price	$4.98
Rate for Payer: Cigna of CA HMO/PPO	$8.85
Rate for Payer: Health Smart Auto/Commercial	$6.64
Rate for Payer: LLUH Dept of Risk Management WC	$6.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.30

ROSUVASTATIN 10 MG TABLET [35134]

Facility

OP

$11.06

Service Code	NDC 0310-0751-90
Hospital Charge Code	1712304
Hospital Revenue Code	259
Min. Negotiated Rate	$6.08
Max. Negotiated Rate	$8.30
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$6.64
Rate for Payer: Aetna of CA Government/Medicare	$6.64
Rate for Payer: Cash Price	$4.98
Rate for Payer: Health Smart Auto/Commercial	$6.64
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$6.64
Rate for Payer: LLUH Dept of Risk Management WC	$6.08
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$8.30

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