Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

MORPHINE 10 MG/ML INTRAVENOUS SYRINGE

Facility

$29.17

Service Code	HCPCS J2270
Hospital Charge Code	172788
Hospital Revenue Code	636
Min. Negotiated Rate	$11.67
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$24.79
Rate for Payer: Aetna Medicare	$14.59
Rate for Payer: Aetna New Business (MI Preferred)	$18.96
Rate for Payer: BCBS Complete	$11.67
Rate for Payer: Cash Price	$23.34
Rate for Payer: Cofinity Commercial	$20.42
Rate for Payer: Cofinity Commercial	$25.09
Rate for Payer: Cofinity Medicare Advantage	$20.42
Rate for Payer: Encore Health Key Benefits Commercial	$23.34
Rate for Payer: Healthscope Commercial	$26.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.79
Rate for Payer: PHP Commercial	$24.79
Rate for Payer: Priority Health Cigna Priority Health	$18.96
Rate for Payer: Priority Health SBD	$18.38

MORPHINE 10 MG/ML INTRAVENOUS SYRINGE

Facility

$29.17

Service Code	HCPCS J2270
Hospital Charge Code	172788
Hospital Revenue Code	636
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$26.25
Rate for Payer: Aetna Commercial	$24.79
Rate for Payer: Aetna New Business (MI Preferred)	$18.96
Rate for Payer: Cash Price	$23.34
Rate for Payer: Cofinity Commercial	$20.42
Rate for Payer: Cofinity Commercial	$25.09
Rate for Payer: Cofinity Medicare Advantage	$20.42
Rate for Payer: Encore Health Key Benefits Commercial	$23.34
Rate for Payer: Healthscope Commercial	$26.25
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$24.79
Rate for Payer: PHP Commercial	$24.79
Rate for Payer: Priority Health Cigna Priority Health	$18.96
Rate for Payer: Priority Health SBD	$18.38

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$4.94

Service Code	NDC 00406511823
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$4.45
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna Medicare	$2.47
Rate for Payer: Aetna New Business (MI Preferred)	$3.21
Rate for Payer: BCBS Complete	$1.98
Rate for Payer: Cash Price	$3.95
Rate for Payer: Cofinity Commercial	$3.46
Rate for Payer: Cofinity Commercial	$4.25
Rate for Payer: Cofinity Medicare Advantage	$3.46
Rate for Payer: Encore Health Key Benefits Commercial	$3.95
Rate for Payer: Healthscope Commercial	$4.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.20
Rate for Payer: PHP Commercial	$4.20
Rate for Payer: Priority Health Cigna Priority Health	$3.21
Rate for Payer: Priority Health SBD	$3.11

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$493.50

Service Code	NDC 00406511862
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$197.40
Max. Negotiated Rate	$444.15
Rate for Payer: Aetna Commercial	$419.48
Rate for Payer: Aetna Medicare	$246.75
Rate for Payer: Aetna New Business (MI Preferred)	$320.77
Rate for Payer: BCBS Complete	$197.40
Rate for Payer: Cash Price	$394.80
Rate for Payer: Cofinity Commercial	$345.45
Rate for Payer: Cofinity Commercial	$424.41
Rate for Payer: Cofinity Medicare Advantage	$345.45
Rate for Payer: Encore Health Key Benefits Commercial	$394.80
Rate for Payer: Healthscope Commercial	$444.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$419.48
Rate for Payer: PHP Commercial	$419.48
Rate for Payer: Priority Health Cigna Priority Health	$320.77
Rate for Payer: Priority Health SBD	$310.90

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$4.94

Service Code	NDC 00406511823
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$4.45
Rate for Payer: Aetna Commercial	$4.20
Rate for Payer: Aetna New Business (MI Preferred)	$3.21
Rate for Payer: Cash Price	$3.95
Rate for Payer: Cofinity Commercial	$3.46
Rate for Payer: Cofinity Commercial	$4.25
Rate for Payer: Cofinity Medicare Advantage	$3.46
Rate for Payer: Encore Health Key Benefits Commercial	$3.95
Rate for Payer: Healthscope Commercial	$4.45
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.20
Rate for Payer: PHP Commercial	$4.20
Rate for Payer: Priority Health Cigna Priority Health	$3.21
Rate for Payer: Priority Health SBD	$3.11

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$5.11

Service Code	NDC 60687061711
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$4.60
Rate for Payer: Aetna Commercial	$4.34
Rate for Payer: Aetna Medicare	$2.56
Rate for Payer: Aetna New Business (MI Preferred)	$3.32
Rate for Payer: BCBS Complete	$2.04
Rate for Payer: Cash Price	$4.09
Rate for Payer: Cofinity Commercial	$3.58
Rate for Payer: Cofinity Commercial	$4.39
Rate for Payer: Cofinity Medicare Advantage	$3.58
Rate for Payer: Encore Health Key Benefits Commercial	$4.09
Rate for Payer: Healthscope Commercial	$4.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.34
Rate for Payer: PHP Commercial	$4.34
Rate for Payer: Priority Health Cigna Priority Health	$3.32
Rate for Payer: Priority Health SBD	$3.22

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$493.50

Service Code	NDC 00406511862
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$310.90
Max. Negotiated Rate	$444.15
Rate for Payer: Aetna Commercial	$419.48
Rate for Payer: Aetna New Business (MI Preferred)	$320.77
Rate for Payer: Cash Price	$394.80
Rate for Payer: Cofinity Commercial	$345.45
Rate for Payer: Cofinity Commercial	$424.41
Rate for Payer: Cofinity Medicare Advantage	$345.45
Rate for Payer: Encore Health Key Benefits Commercial	$394.80
Rate for Payer: Healthscope Commercial	$444.15
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$419.48
Rate for Payer: PHP Commercial	$419.48
Rate for Payer: Priority Health Cigna Priority Health	$320.77
Rate for Payer: Priority Health SBD	$310.90

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$5.11

Service Code	NDC 60687061711
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$4.60
Rate for Payer: Aetna Commercial	$4.34
Rate for Payer: Aetna New Business (MI Preferred)	$3.32
Rate for Payer: Cash Price	$4.09
Rate for Payer: Cofinity Commercial	$3.58
Rate for Payer: Cofinity Commercial	$4.39
Rate for Payer: Cofinity Medicare Advantage	$3.58
Rate for Payer: Encore Health Key Benefits Commercial	$4.09
Rate for Payer: Healthscope Commercial	$4.60
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$4.34
Rate for Payer: PHP Commercial	$4.34
Rate for Payer: Priority Health Cigna Priority Health	$3.32
Rate for Payer: Priority Health SBD	$3.22

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$511.00

Service Code	NDC 60687061701
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$204.40
Max. Negotiated Rate	$459.90
Rate for Payer: Aetna Commercial	$434.35
Rate for Payer: Aetna Medicare	$255.50
Rate for Payer: Aetna New Business (MI Preferred)	$332.15
Rate for Payer: BCBS Complete	$204.40
Rate for Payer: Cash Price	$408.80
Rate for Payer: Cofinity Commercial	$357.70
Rate for Payer: Cofinity Commercial	$439.46
Rate for Payer: Cofinity Medicare Advantage	$357.70
Rate for Payer: Encore Health Key Benefits Commercial	$408.80
Rate for Payer: Healthscope Commercial	$459.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$434.35
Rate for Payer: PHP Commercial	$434.35
Rate for Payer: Priority Health Cigna Priority Health	$332.15
Rate for Payer: Priority Health SBD	$321.93

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$511.00

Service Code	NDC 60687061701
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$321.93
Max. Negotiated Rate	$459.90
Rate for Payer: Aetna Commercial	$434.35
Rate for Payer: Aetna New Business (MI Preferred)	$332.15
Rate for Payer: Cash Price	$408.80
Rate for Payer: Cofinity Commercial	$357.70
Rate for Payer: Cofinity Commercial	$439.46
Rate for Payer: Cofinity Medicare Advantage	$357.70
Rate for Payer: Encore Health Key Benefits Commercial	$408.80
Rate for Payer: Healthscope Commercial	$459.90
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$434.35
Rate for Payer: PHP Commercial	$434.35
Rate for Payer: Priority Health Cigna Priority Health	$332.15
Rate for Payer: Priority Health SBD	$321.93

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$123.38

Service Code	NDC 00054023524
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$77.73
Max. Negotiated Rate	$111.04
Rate for Payer: Aetna Commercial	$104.87
Rate for Payer: Aetna New Business (MI Preferred)	$80.20
Rate for Payer: Cash Price	$98.70
Rate for Payer: Cofinity Commercial	$106.11
Rate for Payer: Cofinity Commercial	$86.37
Rate for Payer: Cofinity Medicare Advantage	$86.37
Rate for Payer: Encore Health Key Benefits Commercial	$98.70
Rate for Payer: Healthscope Commercial	$111.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$104.87
Rate for Payer: PHP Commercial	$104.87
Rate for Payer: Priority Health Cigna Priority Health	$80.20
Rate for Payer: Priority Health SBD	$77.73

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$123.38

Service Code	NDC 00054023524
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$49.35
Max. Negotiated Rate	$111.04
Rate for Payer: Aetna Commercial	$104.87
Rate for Payer: Aetna Medicare	$61.69
Rate for Payer: Aetna New Business (MI Preferred)	$80.20
Rate for Payer: BCBS Complete	$49.35
Rate for Payer: Cash Price	$98.70
Rate for Payer: Cofinity Commercial	$106.11
Rate for Payer: Cofinity Commercial	$86.37
Rate for Payer: Cofinity Medicare Advantage	$86.37
Rate for Payer: Encore Health Key Benefits Commercial	$98.70
Rate for Payer: Healthscope Commercial	$111.04
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$104.87
Rate for Payer: PHP Commercial	$104.87
Rate for Payer: Priority Health Cigna Priority Health	$80.20
Rate for Payer: Priority Health SBD	$77.73

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$535.50

Service Code	NDC 00054023525
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$214.20
Max. Negotiated Rate	$481.95
Rate for Payer: Aetna Commercial	$455.18
Rate for Payer: Aetna Medicare	$267.75
Rate for Payer: Aetna New Business (MI Preferred)	$348.07
Rate for Payer: BCBS Complete	$214.20
Rate for Payer: Cash Price	$428.40
Rate for Payer: Cofinity Commercial	$374.85
Rate for Payer: Cofinity Commercial	$460.53
Rate for Payer: Cofinity Medicare Advantage	$374.85
Rate for Payer: Encore Health Key Benefits Commercial	$428.40
Rate for Payer: Healthscope Commercial	$481.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$455.18
Rate for Payer: PHP Commercial	$455.18
Rate for Payer: Priority Health Cigna Priority Health	$348.07
Rate for Payer: Priority Health SBD	$337.37

MORPHINE 15 MG IMMEDIATE RELEASE TABLET

Facility

$535.50

Service Code	NDC 00054023525
Hospital Charge Code	5178
Hospital Revenue Code	637
Min. Negotiated Rate	$337.37
Max. Negotiated Rate	$481.95
Rate for Payer: Aetna Commercial	$455.18
Rate for Payer: Aetna New Business (MI Preferred)	$348.07
Rate for Payer: Cash Price	$428.40
Rate for Payer: Cofinity Commercial	$374.85
Rate for Payer: Cofinity Commercial	$460.53
Rate for Payer: Cofinity Medicare Advantage	$374.85
Rate for Payer: Encore Health Key Benefits Commercial	$428.40
Rate for Payer: Healthscope Commercial	$481.95
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$455.18
Rate for Payer: PHP Commercial	$455.18
Rate for Payer: Priority Health Cigna Priority Health	$348.07
Rate for Payer: Priority Health SBD	$337.37

MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS

Facility

$227.49

Service Code	HCPCS J2270
Hospital Charge Code	30604
Hospital Revenue Code	636
Min. Negotiated Rate	$143.32
Max. Negotiated Rate	$204.74
Rate for Payer: Aetna Commercial	$193.37
Rate for Payer: Aetna New Business (MI Preferred)	$147.87
Rate for Payer: Cash Price	$181.99
Rate for Payer: Cofinity Commercial	$159.24
Rate for Payer: Cofinity Commercial	$195.64
Rate for Payer: Cofinity Medicare Advantage	$159.24
Rate for Payer: Encore Health Key Benefits Commercial	$181.99
Rate for Payer: Healthscope Commercial	$204.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$193.37
Rate for Payer: PHP Commercial	$193.37
Rate for Payer: Priority Health Cigna Priority Health	$147.87
Rate for Payer: Priority Health SBD	$143.32

MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE INTRAVENOUS

Facility

$227.49

Service Code	HCPCS J2270
Hospital Charge Code	30604
Hospital Revenue Code	636
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$204.74
Rate for Payer: Aetna Commercial	$193.37
Rate for Payer: Aetna Medicare	$113.75
Rate for Payer: Aetna New Business (MI Preferred)	$147.87
Rate for Payer: BCBS Complete	$91.00
Rate for Payer: Cash Price	$181.99
Rate for Payer: Cofinity Commercial	$159.24
Rate for Payer: Cofinity Commercial	$195.64
Rate for Payer: Cofinity Medicare Advantage	$159.24
Rate for Payer: Encore Health Key Benefits Commercial	$181.99
Rate for Payer: Healthscope Commercial	$204.74
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$193.37
Rate for Payer: PHP Commercial	$193.37
Rate for Payer: Priority Health Cigna Priority Health	$147.87
Rate for Payer: Priority Health SBD	$143.32

MORPHINE 2 MG/ML INJECTION SYRINGE

Facility

$18.75

Service Code	HCPCS J2270
Hospital Charge Code	5170
Hospital Revenue Code	636
Min. Negotiated Rate	$11.81
Max. Negotiated Rate	$16.88
Rate for Payer: Aetna Commercial	$15.94
Rate for Payer: Aetna Commercial	$22.75
Rate for Payer: Aetna New Business (MI Preferred)	$12.19
Rate for Payer: Aetna New Business (MI Preferred)	$17.39
Rate for Payer: Cash Price	$15.00
Rate for Payer: Cash Price	$21.41
Rate for Payer: Cofinity Commercial	$13.12
Rate for Payer: Cofinity Commercial	$18.73
Rate for Payer: Cofinity Commercial	$23.01
Rate for Payer: Cofinity Commercial	$16.12
Rate for Payer: Cofinity Medicare Advantage	$18.73
Rate for Payer: Cofinity Medicare Advantage	$13.12
Rate for Payer: Encore Health Key Benefits Commercial	$15.00
Rate for Payer: Encore Health Key Benefits Commercial	$21.41
Rate for Payer: Healthscope Commercial	$16.88
Rate for Payer: Healthscope Commercial	$24.08
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.94
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.75
Rate for Payer: PHP Commercial	$15.94
Rate for Payer: PHP Commercial	$22.75
Rate for Payer: Priority Health Cigna Priority Health	$17.39
Rate for Payer: Priority Health Cigna Priority Health	$12.19
Rate for Payer: Priority Health SBD	$16.86
Rate for Payer: Priority Health SBD	$11.81

MORPHINE 2 MG/ML INJECTION SYRINGE

Facility

$26.76

Service Code	HCPCS J2270
Hospital Charge Code	5170
Hospital Revenue Code	636
Min. Negotiated Rate	$10.70
Max. Negotiated Rate	$24.08
Rate for Payer: Aetna Commercial	$22.75
Rate for Payer: Aetna Commercial	$15.94
Rate for Payer: Aetna Medicare	$9.38
Rate for Payer: Aetna Medicare	$13.38
Rate for Payer: Aetna New Business (MI Preferred)	$17.39
Rate for Payer: Aetna New Business (MI Preferred)	$12.19
Rate for Payer: BCBS Complete	$10.70
Rate for Payer: BCBS Complete	$7.50
Rate for Payer: Cash Price	$21.41
Rate for Payer: Cash Price	$15.00
Rate for Payer: Cofinity Commercial	$23.01
Rate for Payer: Cofinity Commercial	$13.12
Rate for Payer: Cofinity Commercial	$16.12
Rate for Payer: Cofinity Commercial	$18.73
Rate for Payer: Cofinity Medicare Advantage	$13.12
Rate for Payer: Cofinity Medicare Advantage	$18.73
Rate for Payer: Encore Health Key Benefits Commercial	$15.00
Rate for Payer: Encore Health Key Benefits Commercial	$21.41
Rate for Payer: Healthscope Commercial	$24.08
Rate for Payer: Healthscope Commercial	$16.88
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$22.75
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$15.94
Rate for Payer: PHP Commercial	$22.75
Rate for Payer: PHP Commercial	$15.94
Rate for Payer: Priority Health Cigna Priority Health	$12.19
Rate for Payer: Priority Health Cigna Priority Health	$17.39
Rate for Payer: Priority Health SBD	$11.81
Rate for Payer: Priority Health SBD	$16.86

MORPHINE 2 MG/ML INJECTION SYRINGE

Facility

$29.77

Service Code	HCPCS J2272
Hospital Charge Code	5170
Hospital Revenue Code	636
Min. Negotiated Rate	$11.91
Max. Negotiated Rate	$26.79
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare	$14.88
Rate for Payer: Aetna New Business (MI Preferred)	$19.35
Rate for Payer: BCBS Complete	$11.91
Rate for Payer: Cash Price	$23.82
Rate for Payer: Cofinity Commercial	$20.84
Rate for Payer: Cofinity Commercial	$25.60
Rate for Payer: Cofinity Medicare Advantage	$20.84
Rate for Payer: Encore Health Key Benefits Commercial	$23.82
Rate for Payer: Healthscope Commercial	$26.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.30
Rate for Payer: PHP Commercial	$25.30
Rate for Payer: Priority Health Cigna Priority Health	$19.35
Rate for Payer: Priority Health SBD	$18.76

MORPHINE 2 MG/ML INJECTION SYRINGE

Facility

$29.77

Service Code	HCPCS J2272
Hospital Charge Code	5170
Hospital Revenue Code	636
Min. Negotiated Rate	$18.76
Max. Negotiated Rate	$26.79
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna New Business (MI Preferred)	$19.35
Rate for Payer: Cash Price	$23.82
Rate for Payer: Cofinity Commercial	$20.84
Rate for Payer: Cofinity Commercial	$25.60
Rate for Payer: Cofinity Medicare Advantage	$20.84
Rate for Payer: Encore Health Key Benefits Commercial	$23.82
Rate for Payer: Healthscope Commercial	$26.79
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$25.30
Rate for Payer: PHP Commercial	$25.30
Rate for Payer: Priority Health Cigna Priority Health	$19.35
Rate for Payer: Priority Health SBD	$18.76

MORPHINE 30 MG IMMEDIATE RELEASE TABLET

Facility

$837.90

Service Code	NDC 00054023624
Hospital Charge Code	5179
Hospital Revenue Code	637
Min. Negotiated Rate	$335.16
Max. Negotiated Rate	$754.11
Rate for Payer: Aetna Commercial	$712.22
Rate for Payer: Aetna Medicare	$418.95
Rate for Payer: Aetna New Business (MI Preferred)	$544.63
Rate for Payer: BCBS Complete	$335.16
Rate for Payer: Cash Price	$670.32
Rate for Payer: Cofinity Commercial	$586.53
Rate for Payer: Cofinity Commercial	$720.59
Rate for Payer: Cofinity Medicare Advantage	$586.53
Rate for Payer: Encore Health Key Benefits Commercial	$670.32
Rate for Payer: Healthscope Commercial	$754.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$712.22
Rate for Payer: PHP Commercial	$712.22
Rate for Payer: Priority Health Cigna Priority Health	$544.63
Rate for Payer: Priority Health SBD	$527.88

MORPHINE 30 MG IMMEDIATE RELEASE TABLET

Facility

$910.00

Service Code	NDC 00054023625
Hospital Charge Code	5179
Hospital Revenue Code	637
Min. Negotiated Rate	$364.00
Max. Negotiated Rate	$819.00
Rate for Payer: Aetna Commercial	$773.50
Rate for Payer: Aetna Medicare	$455.00
Rate for Payer: Aetna New Business (MI Preferred)	$591.50
Rate for Payer: BCBS Complete	$364.00
Rate for Payer: Cash Price	$728.00
Rate for Payer: Cofinity Commercial	$637.00
Rate for Payer: Cofinity Commercial	$782.60
Rate for Payer: Cofinity Medicare Advantage	$637.00
Rate for Payer: Encore Health Key Benefits Commercial	$728.00
Rate for Payer: Healthscope Commercial	$819.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$773.50
Rate for Payer: PHP Commercial	$773.50
Rate for Payer: Priority Health Cigna Priority Health	$591.50
Rate for Payer: Priority Health SBD	$573.30

MORPHINE 30 MG IMMEDIATE RELEASE TABLET

Facility

$910.00

Service Code	NDC 00054023625
Hospital Charge Code	5179
Hospital Revenue Code	637
Min. Negotiated Rate	$573.30
Max. Negotiated Rate	$819.00
Rate for Payer: Aetna Commercial	$773.50
Rate for Payer: Aetna New Business (MI Preferred)	$591.50
Rate for Payer: Cash Price	$728.00
Rate for Payer: Cofinity Commercial	$637.00
Rate for Payer: Cofinity Commercial	$782.60
Rate for Payer: Cofinity Medicare Advantage	$637.00
Rate for Payer: Encore Health Key Benefits Commercial	$728.00
Rate for Payer: Healthscope Commercial	$819.00
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$773.50
Rate for Payer: PHP Commercial	$773.50
Rate for Payer: Priority Health Cigna Priority Health	$591.50
Rate for Payer: Priority Health SBD	$573.30

MORPHINE 30 MG IMMEDIATE RELEASE TABLET

Facility

$837.90

Service Code	NDC 00054023624
Hospital Charge Code	5179
Hospital Revenue Code	637
Min. Negotiated Rate	$527.88
Max. Negotiated Rate	$754.11
Rate for Payer: Aetna Commercial	$712.22
Rate for Payer: Aetna New Business (MI Preferred)	$544.63
Rate for Payer: Cash Price	$670.32
Rate for Payer: Cofinity Commercial	$586.53
Rate for Payer: Cofinity Commercial	$720.59
Rate for Payer: Cofinity Medicare Advantage	$586.53
Rate for Payer: Encore Health Key Benefits Commercial	$670.32
Rate for Payer: Healthscope Commercial	$754.11
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$712.22
Rate for Payer: PHP Commercial	$712.22
Rate for Payer: Priority Health Cigna Priority Health	$544.63
Rate for Payer: Priority Health SBD	$527.88

MORPHINE 4 MG/ML INJECTION SOLUTION

Facility

$30.64

Service Code	HCPCS J2272
Hospital Charge Code	186563
Hospital Revenue Code	636
Min. Negotiated Rate	$19.30
Max. Negotiated Rate	$27.58
Rate for Payer: Aetna Commercial	$26.04
Rate for Payer: Aetna New Business (MI Preferred)	$19.92
Rate for Payer: Cash Price	$24.51
Rate for Payer: Cofinity Commercial	$21.45
Rate for Payer: Cofinity Commercial	$26.35
Rate for Payer: Cofinity Medicare Advantage	$21.45
Rate for Payer: Encore Health Key Benefits Commercial	$24.51
Rate for Payer: Healthscope Commercial	$27.58
Rate for Payer: Multiplan/Beech St/PHCS Commercial	$26.04
Rate for Payer: PHP Commercial	$26.04
Rate for Payer: Priority Health Cigna Priority Health	$19.92
Rate for Payer: Priority Health SBD	$19.30

Know your out-of-pocket cost for care.

All Charges