Madison Medical Center

All Charges

Charge

Type

Setting

Price

ROPINIROLE 4MG ER TAB EMP

Facility

$13.00

Service Code	NDC 228365903
Hospital Charge Code	2626035
Hospital Revenue Code	250
Rate for Payer: Cash Price	$11.70

ROPINIROLE 4MG ER TAB EMP

Facility

$13.00

Service Code	NDC 228365903
Hospital Charge Code	2626035
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$9.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$9.28
Rate for Payer: Cash Price	$11.70
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.68

ROPINIROLE 4MG TAB EMP

Facility

$13.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2621356
Hospital Revenue Code	250
Rate for Payer: Cash Price	$11.70

ROPINIROLE 4MG TAB EMP

Facility

$13.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2621356
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$9.28
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$7.70
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$9.28
Rate for Payer: Cash Price	$11.70
Rate for Payer: UnitedHealthcare Commercial	$8.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.68

ROPINIROLE (REQUIP) 0.25MG TAB EMP

Facility

$19.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2622375
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

ROPINIROLE (REQUIP) 0.25MG TAB EMP

Facility

$19.00

Service Code	NDC 4.3547E+10
Hospital Charge Code	2622375
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

ROPINIROLE (REQUIP) 0.25MG TAB UD

Facility

$19.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2625885
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

ROPINIROLE (REQUIP) 0.25MG TAB UD

Facility

$19.00

Service Code	NDC 5.0268E+10
Hospital Charge Code	2625885
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

ROPINIROLE (REQUIP) 0.5MG TAB EMP

Facility

$19.00

Service Code	NDC 6.2332E+10
Hospital Charge Code	2622217
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

ROPINIROLE (REQUIP) 0.5MG TAB EMP

Facility

$19.00

Service Code	NDC 6.2332E+10
Hospital Charge Code	2622217
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

ROPINIROLE (REQUIP) 1MG TAB

Facility

$19.00

Service Code	NDC 904637461
Hospital Charge Code	2626503
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

ROPINIROLE (REQUIP) 1MG TAB

Facility

$19.00

Service Code	NDC 904637461
Hospital Charge Code	2626503
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

ROPINIROLE (REQUIP) 1MG TAB EMP

Facility

$19.00

Service Code	NDC 6.8462E+10
Hospital Charge Code	2621879
Hospital Revenue Code	250
Rate for Payer: Cash Price	$17.10

ROPINIROLE (REQUIP) 1MG TAB EMP

Facility

$19.00

Service Code	NDC 6.8462E+10
Hospital Charge Code	2621879
Hospital Revenue Code	250
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$13.57
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$11.25
Rate for Payer: Cash Price	$17.10
Rate for Payer: UnitedHealthcare Commercial	$12.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.84

ROPINIROLE (REQUIP) 2MG TAB EMP

Facility

$18.00

Service Code	NDC 54011925
Hospital Charge Code	2619230
Hospital Revenue Code	250
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$12.85
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$10.66
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$12.85
Rate for Payer: Cash Price	$16.20
Rate for Payer: UnitedHealthcare Commercial	$12.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48

ROPINIROLE (REQUIP) 2MG TAB EMP

Facility

$18.00

Service Code	NDC 54011925
Hospital Charge Code	2619230
Hospital Revenue Code	250
Rate for Payer: Cash Price	$16.20

ROSUVASTATIN 10MG TAB EMP

Facility

$47.00

Service Code	NDC 4.2292E+10
Hospital Charge Code	2621438
Hospital Revenue Code	250
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$33.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$27.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$33.56
Rate for Payer: Cash Price	$42.30
Rate for Payer: UnitedHealthcare Commercial	$31.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.92

ROSUVASTATIN 10MG TAB EMP

Facility

$47.00

Service Code	NDC 4.2292E+10
Hospital Charge Code	2621438
Hospital Revenue Code	250
Rate for Payer: Cash Price	$42.30

ROSUVASTATIN 20MG TAB EMP

Facility

$47.00

Service Code	NDC 5.7237E+10
Hospital Charge Code	2621939
Hospital Revenue Code	250
Rate for Payer: Cash Price	$42.30

ROSUVASTATIN 20MG TAB EMP

Facility

$47.00

Service Code	NDC 5.7237E+10
Hospital Charge Code	2621939
Hospital Revenue Code	250
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$33.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$27.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$33.56
Rate for Payer: Cash Price	$42.30
Rate for Payer: UnitedHealthcare Commercial	$31.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.92

ROSUVASTATIN 20MG TAB HE

Facility

$47.00

Service Code	NDC 1.6714E+10
Hospital Charge Code	2625491
Hospital Revenue Code	250
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$33.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$27.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$33.56
Rate for Payer: Cash Price	$42.30
Rate for Payer: UnitedHealthcare Commercial	$31.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.92

ROSUVASTATIN 20MG TAB HE

Facility

$47.00

Service Code	NDC 1.6714E+10
Hospital Charge Code	2625491
Hospital Revenue Code	250
Rate for Payer: Cash Price	$42.30

ROSUVASTATIN 40MG TAB EMP

Facility

$47.00

Service Code	NDC 6.8462E+10
Hospital Charge Code	2625624
Hospital Revenue Code	250
Rate for Payer: Cash Price	$42.30

ROSUVASTATIN 40MG TAB EMP

Facility

$47.00

Service Code	NDC 6.8462E+10
Hospital Charge Code	2625624
Hospital Revenue Code	250
Min. Negotiated Rate	$16.92
Max. Negotiated Rate	$33.56
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X	$27.82
Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional	$33.56
Rate for Payer: Cash Price	$42.30
Rate for Payer: UnitedHealthcare Commercial	$31.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.92

ROSUVASTATIN 5MG TAB EMP

Facility

$47.00

Service Code	NDC 1.6714E+10
Hospital Charge Code	2622695
Hospital Revenue Code	250
Rate for Payer: Cash Price	$42.30

Know your out-of-pocket cost for care.

All Charges