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If the hospital is unable to display a payer-specific negotiated charge solely as a dollar amount, such as when the payer-specific negotiated charge is further modified by a percentage or algorithm, the hospital will be required to provide all necessary information available to the hospital to derive a dollar amount

10.1016/j.cpm.2017.08.010 18 BrufaniM.CeccacciF.FilocamoL.GarofaloB.JoudiouxR.BellaA

A drug on Tier 3 with a $75 copay faces approximately 25-40% demand reduction compared to a Tier 2 equivalent at $30, controlling for clinical differentiation

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