|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.44
|
|
|
Service Code
|
NDC 68094004558
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$10.30 |
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$9.45
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$9.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: PHP Commercial |
$9.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.07
|
| Rate for Payer: UHC Core |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.58
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.68
|
|
|
Service Code
|
NDC 68094005658
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: Aetna Medicare |
$3.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.65
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.60
|
| Rate for Payer: BCN Commercial |
$9.60
|
| Rate for Payer: BCN Medicare Advantage |
$2.92
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Mclaren Medicaid |
$2.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.07
|
| Rate for Payer: Meridian Medicaid |
$2.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PACE Senior Care Partners |
$2.77
|
| Rate for Payer: PACE SWMI |
$2.92
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$2.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Medicare |
$2.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: UHC Exchange |
$2.92
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHC Medicare Advantage |
$2.92
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$2.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.68
|
|
|
Service Code
|
NDC 68094005658
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: BCBS Trust/PPO |
$9.65
|
| Rate for Payer: BCN Commercial |
$9.65
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.44
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$10.30 |
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: BCBS Trust/PPO |
$9.45
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$9.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: PHP Commercial |
$9.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.07
|
| Rate for Payer: UHC Core |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.58
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.44
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.02 |
| Max. Negotiated Rate |
$10.30 |
| Rate for Payer: Aetna Commercial |
$9.72
|
| Rate for Payer: Aetna Medicare |
$2.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.58
|
| Rate for Payer: BCBS Complete |
$2.12
|
| Rate for Payer: BCBS MAPPO |
$2.86
|
| Rate for Payer: BCBS Trust/PPO |
$9.40
|
| Rate for Payer: BCN Commercial |
$9.40
|
| Rate for Payer: BCN Medicare Advantage |
$2.86
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$9.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.86
|
| Rate for Payer: Healthscope Commercial |
$10.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.58
|
| Rate for Payer: Mclaren Medicaid |
$2.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.00
|
| Rate for Payer: Meridian Medicaid |
$2.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: PACE Senior Care Partners |
$2.72
|
| Rate for Payer: PACE SWMI |
$2.86
|
| Rate for Payer: PHP Commercial |
$9.72
|
| Rate for Payer: PHP Medicare Advantage |
$2.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.95
|
| Rate for Payer: Priority Health Medicare |
$2.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.96
|
| Rate for Payer: Railroad Medicare Medicare |
$2.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.07
|
| Rate for Payer: UHC Core |
$9.55
|
| Rate for Payer: UHC Exchange |
$2.86
|
| Rate for Payer: UHC Medicaid |
$2.02
|
| Rate for Payer: UHC Medicare Advantage |
$2.86
|
| Rate for Payer: UHCCP Medicaid |
$2.02
|
| Rate for Payer: VA VA |
$2.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.58
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.68
|
|
|
Service Code
|
NDC 68094005601
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: Aetna Medicare |
$3.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.65
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.60
|
| Rate for Payer: BCN Commercial |
$9.60
|
| Rate for Payer: BCN Medicare Advantage |
$2.92
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Mclaren Medicaid |
$2.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.07
|
| Rate for Payer: Meridian Medicaid |
$2.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PACE Senior Care Partners |
$2.77
|
| Rate for Payer: PACE SWMI |
$2.92
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$2.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Medicare |
$2.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: UHC Exchange |
$2.92
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHC Medicare Advantage |
$2.92
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$2.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$532.00
|
|
|
Service Code
|
NDC 00904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$370.27 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Aetna Commercial |
$452.20
|
| Rate for Payer: BCBS Trust/PPO |
$439.38
|
| Rate for Payer: BCN Commercial |
$439.38
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$457.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.60
|
| Rate for Payer: Healthscope Commercial |
$478.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.20
|
| Rate for Payer: Nomi Health Commercial |
$436.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.00
|
| Rate for Payer: PHP Commercial |
$452.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$462.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.16
|
| Rate for Payer: UHC Core |
$444.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.00
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$561.75
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$99.04 |
| Max. Negotiated Rate |
$505.57 |
| Rate for Payer: Aetna Commercial |
$477.49
|
| Rate for Payer: Aetna Medicare |
$146.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.55
|
| Rate for Payer: BCBS Complete |
$103.98
|
| Rate for Payer: BCBS MAPPO |
$140.44
|
| Rate for Payer: BCBS Trust/PPO |
$461.81
|
| Rate for Payer: BCN Commercial |
$461.81
|
| Rate for Payer: BCN Medicare Advantage |
$140.44
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cofinity Commercial |
$483.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.44
|
| Rate for Payer: Healthscope Commercial |
$505.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.31
|
| Rate for Payer: Mclaren Medicaid |
$99.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.46
|
| Rate for Payer: Meridian Medicaid |
$103.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.49
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.31
|
| Rate for Payer: PACE Senior Care Partners |
$133.42
|
| Rate for Payer: PACE SWMI |
$140.44
|
| Rate for Payer: PHP Commercial |
$477.49
|
| Rate for Payer: PHP Medicare Advantage |
$140.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$488.72
|
| Rate for Payer: Priority Health Medicare |
$141.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.98
|
| Rate for Payer: Railroad Medicare Medicare |
$140.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.34
|
| Rate for Payer: UHC Core |
$469.06
|
| Rate for Payer: UHC Exchange |
$140.44
|
| Rate for Payer: UHC Medicaid |
$99.04
|
| Rate for Payer: UHC Medicare Advantage |
$140.44
|
| Rate for Payer: UHCCP Medicaid |
$99.04
|
| Rate for Payer: VA VA |
$140.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.31
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$586.60
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$408.27 |
| Max. Negotiated Rate |
$527.94 |
| Rate for Payer: Aetna Commercial |
$498.61
|
| Rate for Payer: BCBS Trust/PPO |
$484.47
|
| Rate for Payer: BCN Commercial |
$484.47
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Commercial |
$504.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Healthscope Commercial |
$527.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Nomi Health Commercial |
$481.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: PHP Commercial |
$498.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$510.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$408.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.21
|
| Rate for Payer: UHC Core |
$489.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.95
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$561.75
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$390.98 |
| Max. Negotiated Rate |
$505.57 |
| Rate for Payer: Aetna Commercial |
$477.49
|
| Rate for Payer: BCBS Trust/PPO |
$463.95
|
| Rate for Payer: BCN Commercial |
$463.95
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cofinity Commercial |
$483.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.40
|
| Rate for Payer: Healthscope Commercial |
$505.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.49
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.31
|
| Rate for Payer: PHP Commercial |
$477.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$488.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$390.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$494.34
|
| Rate for Payer: UHC Core |
$469.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.31
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$532.00
|
|
|
Service Code
|
NDC 00904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$93.79 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Aetna Commercial |
$452.20
|
| Rate for Payer: Aetna Medicare |
$138.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$166.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$166.25
|
| Rate for Payer: BCBS Complete |
$98.47
|
| Rate for Payer: BCBS MAPPO |
$133.00
|
| Rate for Payer: BCBS Trust/PPO |
$437.36
|
| Rate for Payer: BCN Commercial |
$437.36
|
| Rate for Payer: BCN Medicare Advantage |
$133.00
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$457.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.00
|
| Rate for Payer: Healthscope Commercial |
$478.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.00
|
| Rate for Payer: Mclaren Medicaid |
$93.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.65
|
| Rate for Payer: Meridian Medicaid |
$98.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$146.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.20
|
| Rate for Payer: Nomi Health Commercial |
$436.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.00
|
| Rate for Payer: PACE Senior Care Partners |
$126.35
|
| Rate for Payer: PACE SWMI |
$133.00
|
| Rate for Payer: PHP Commercial |
$452.20
|
| Rate for Payer: PHP Medicare Advantage |
$133.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$462.84
|
| Rate for Payer: Priority Health Medicare |
$134.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.27
|
| Rate for Payer: Railroad Medicare Medicare |
$133.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$468.16
|
| Rate for Payer: UHC Core |
$444.22
|
| Rate for Payer: UHC Exchange |
$133.00
|
| Rate for Payer: UHC Medicaid |
$93.79
|
| Rate for Payer: UHC Medicare Advantage |
$133.00
|
| Rate for Payer: UHCCP Medicaid |
$93.79
|
| Rate for Payer: VA VA |
$133.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.00
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$586.60
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$103.42 |
| Max. Negotiated Rate |
$527.94 |
| Rate for Payer: Aetna Commercial |
$498.61
|
| Rate for Payer: Aetna Medicare |
$152.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.31
|
| Rate for Payer: BCBS Complete |
$108.58
|
| Rate for Payer: BCBS MAPPO |
$146.65
|
| Rate for Payer: BCBS Trust/PPO |
$482.24
|
| Rate for Payer: BCN Commercial |
$482.24
|
| Rate for Payer: BCN Medicare Advantage |
$146.65
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Commercial |
$504.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.65
|
| Rate for Payer: Healthscope Commercial |
$527.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.95
|
| Rate for Payer: Mclaren Medicaid |
$103.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$153.98
|
| Rate for Payer: Meridian Medicaid |
$108.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Nomi Health Commercial |
$481.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: PACE Senior Care Partners |
$139.32
|
| Rate for Payer: PACE SWMI |
$146.65
|
| Rate for Payer: PHP Commercial |
$498.61
|
| Rate for Payer: PHP Medicare Advantage |
$146.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$510.34
|
| Rate for Payer: Priority Health Medicare |
$148.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$408.27
|
| Rate for Payer: Railroad Medicare Medicare |
$146.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$516.21
|
| Rate for Payer: UHC Core |
$489.81
|
| Rate for Payer: UHC Exchange |
$146.65
|
| Rate for Payer: UHC Medicaid |
$103.42
|
| Rate for Payer: UHC Medicare Advantage |
$146.65
|
| Rate for Payer: UHCCP Medicaid |
$103.42
|
| Rate for Payer: VA VA |
$146.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.95
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.87
|
|
|
Service Code
|
NDC 00406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.03 |
| Max. Negotiated Rate |
$5.28 |
| Rate for Payer: Aetna Commercial |
$4.99
|
| Rate for Payer: Aetna Medicare |
$1.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.83
|
| Rate for Payer: BCBS Complete |
$1.09
|
| Rate for Payer: BCBS MAPPO |
$1.47
|
| Rate for Payer: BCBS Trust/PPO |
$4.83
|
| Rate for Payer: BCN Commercial |
$4.83
|
| Rate for Payer: BCN Medicare Advantage |
$1.47
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cofinity Commercial |
$5.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.47
|
| Rate for Payer: Healthscope Commercial |
$5.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.40
|
| Rate for Payer: Mclaren Medicaid |
$1.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.54
|
| Rate for Payer: Meridian Medicaid |
$1.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.99
|
| Rate for Payer: Nomi Health Commercial |
$4.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.40
|
| Rate for Payer: PACE Senior Care Partners |
$1.39
|
| Rate for Payer: PACE SWMI |
$1.47
|
| Rate for Payer: PHP Commercial |
$4.99
|
| Rate for Payer: PHP Medicare Advantage |
$1.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.11
|
| Rate for Payer: Priority Health Medicare |
$1.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.17
|
| Rate for Payer: UHC Core |
$4.90
|
| Rate for Payer: UHC Exchange |
$1.47
|
| Rate for Payer: UHC Medicaid |
$1.03
|
| Rate for Payer: UHC Medicare Advantage |
$1.47
|
| Rate for Payer: UHCCP Medicaid |
$1.03
|
| Rate for Payer: VA VA |
$1.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.40
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.87
|
|
|
Service Code
|
NDC 00406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.09 |
| Max. Negotiated Rate |
$5.28 |
| Rate for Payer: Aetna Commercial |
$4.99
|
| Rate for Payer: BCBS Trust/PPO |
$4.85
|
| Rate for Payer: BCN Commercial |
$4.85
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cofinity Commercial |
$5.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.70
|
| Rate for Payer: Healthscope Commercial |
$5.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.99
|
| Rate for Payer: Nomi Health Commercial |
$4.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.40
|
| Rate for Payer: PHP Commercial |
$4.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.17
|
| Rate for Payer: UHC Core |
$4.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.40
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$8.98
|
|
|
Service Code
|
NDC 68084015811
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$6.25 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna Commercial |
$7.63
|
| Rate for Payer: BCBS Trust/PPO |
$7.42
|
| Rate for Payer: BCN Commercial |
$7.42
|
| Rate for Payer: Cash Price |
$7.18
|
| Rate for Payer: Cofinity Commercial |
$7.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.18
|
| Rate for Payer: Healthscope Commercial |
$8.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$7.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.74
|
| Rate for Payer: PHP Commercial |
$7.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.90
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.74
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$897.40
|
|
|
Service Code
|
NDC 68084015801
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$624.59 |
| Max. Negotiated Rate |
$807.66 |
| Rate for Payer: Aetna Commercial |
$762.79
|
| Rate for Payer: BCBS Trust/PPO |
$741.16
|
| Rate for Payer: BCN Commercial |
$741.16
|
| Rate for Payer: Cash Price |
$717.92
|
| Rate for Payer: Cofinity Commercial |
$771.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$717.92
|
| Rate for Payer: Healthscope Commercial |
$807.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$762.79
|
| Rate for Payer: Nomi Health Commercial |
$735.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.05
|
| Rate for Payer: PHP Commercial |
$762.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$780.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.71
|
| Rate for Payer: UHC Core |
$749.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$813.40
|
|
|
Service Code
|
NDC 00904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$566.13 |
| Max. Negotiated Rate |
$732.06 |
| Rate for Payer: Aetna Commercial |
$691.39
|
| Rate for Payer: BCBS Trust/PPO |
$671.79
|
| Rate for Payer: BCN Commercial |
$671.79
|
| Rate for Payer: Cash Price |
$650.72
|
| Rate for Payer: Cofinity Commercial |
$699.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.72
|
| Rate for Payer: Healthscope Commercial |
$732.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.39
|
| Rate for Payer: Nomi Health Commercial |
$666.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.05
|
| Rate for Payer: PHP Commercial |
$691.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.79
|
| Rate for Payer: UHC Core |
$679.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$813.40
|
|
|
Service Code
|
NDC 00904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$143.40 |
| Max. Negotiated Rate |
$732.06 |
| Rate for Payer: Aetna Commercial |
$691.39
|
| Rate for Payer: Aetna Medicare |
$211.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.19
|
| Rate for Payer: BCBS Complete |
$150.56
|
| Rate for Payer: BCBS MAPPO |
$203.35
|
| Rate for Payer: BCBS Trust/PPO |
$668.70
|
| Rate for Payer: BCN Commercial |
$668.70
|
| Rate for Payer: BCN Medicare Advantage |
$203.35
|
| Rate for Payer: Cash Price |
$650.72
|
| Rate for Payer: Cofinity Commercial |
$699.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.35
|
| Rate for Payer: Healthscope Commercial |
$732.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.05
|
| Rate for Payer: Mclaren Medicaid |
$143.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.52
|
| Rate for Payer: Meridian Medicaid |
$150.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$233.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.39
|
| Rate for Payer: Nomi Health Commercial |
$666.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.05
|
| Rate for Payer: PACE Senior Care Partners |
$193.18
|
| Rate for Payer: PACE SWMI |
$203.35
|
| Rate for Payer: PHP Commercial |
$691.39
|
| Rate for Payer: PHP Medicare Advantage |
$203.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$707.66
|
| Rate for Payer: Priority Health Medicare |
$205.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.13
|
| Rate for Payer: Railroad Medicare Medicare |
$203.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$715.79
|
| Rate for Payer: UHC Core |
$679.19
|
| Rate for Payer: UHC Exchange |
$203.35
|
| Rate for Payer: UHC Medicaid |
$143.40
|
| Rate for Payer: UHC Medicare Advantage |
$203.35
|
| Rate for Payer: UHCCP Medicaid |
$143.40
|
| Rate for Payer: VA VA |
$203.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$789.25
|
|
|
Service Code
|
NDC 42858080201
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$549.32 |
| Max. Negotiated Rate |
$710.33 |
| Rate for Payer: Aetna Commercial |
$670.86
|
| Rate for Payer: BCBS Trust/PPO |
$651.84
|
| Rate for Payer: BCN Commercial |
$651.84
|
| Rate for Payer: Cash Price |
$631.40
|
| Rate for Payer: Cofinity Commercial |
$678.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.40
|
| Rate for Payer: Healthscope Commercial |
$710.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.86
|
| Rate for Payer: Nomi Health Commercial |
$647.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.94
|
| Rate for Payer: PHP Commercial |
$670.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$686.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.54
|
| Rate for Payer: UHC Core |
$659.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$789.25
|
|
|
Service Code
|
NDC 42858080201
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.14 |
| Max. Negotiated Rate |
$710.33 |
| Rate for Payer: Aetna Commercial |
$670.86
|
| Rate for Payer: Aetna Medicare |
$205.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$246.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$246.64
|
| Rate for Payer: BCBS Complete |
$146.09
|
| Rate for Payer: BCBS MAPPO |
$197.31
|
| Rate for Payer: BCBS Trust/PPO |
$648.84
|
| Rate for Payer: BCN Commercial |
$648.84
|
| Rate for Payer: BCN Medicare Advantage |
$197.31
|
| Rate for Payer: Cash Price |
$631.40
|
| Rate for Payer: Cofinity Commercial |
$678.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.31
|
| Rate for Payer: Healthscope Commercial |
$710.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.94
|
| Rate for Payer: Mclaren Medicaid |
$139.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.18
|
| Rate for Payer: Meridian Medicaid |
$146.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$217.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.86
|
| Rate for Payer: Nomi Health Commercial |
$647.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.94
|
| Rate for Payer: PACE Senior Care Partners |
$187.45
|
| Rate for Payer: PACE SWMI |
$197.31
|
| Rate for Payer: PHP Commercial |
$670.86
|
| Rate for Payer: PHP Medicare Advantage |
$197.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$139.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$686.65
|
| Rate for Payer: Priority Health Medicare |
$199.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$549.32
|
| Rate for Payer: Railroad Medicare Medicare |
$197.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$694.54
|
| Rate for Payer: UHC Core |
$659.02
|
| Rate for Payer: UHC Exchange |
$197.31
|
| Rate for Payer: UHC Medicaid |
$139.14
|
| Rate for Payer: UHC Medicare Advantage |
$197.31
|
| Rate for Payer: UHCCP Medicaid |
$139.14
|
| Rate for Payer: VA VA |
$197.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$897.40
|
|
|
Service Code
|
NDC 68084015801
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$158.21 |
| Max. Negotiated Rate |
$807.66 |
| Rate for Payer: Aetna Commercial |
$762.79
|
| Rate for Payer: Aetna Medicare |
$233.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$280.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$280.44
|
| Rate for Payer: BCBS Complete |
$166.11
|
| Rate for Payer: BCBS MAPPO |
$224.35
|
| Rate for Payer: BCBS Trust/PPO |
$737.75
|
| Rate for Payer: BCN Commercial |
$737.75
|
| Rate for Payer: BCN Medicare Advantage |
$224.35
|
| Rate for Payer: Cash Price |
$717.92
|
| Rate for Payer: Cofinity Commercial |
$771.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$717.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.35
|
| Rate for Payer: Healthscope Commercial |
$807.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.05
|
| Rate for Payer: Mclaren Medicaid |
$158.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$235.57
|
| Rate for Payer: Meridian Medicaid |
$166.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$258.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$246.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$762.79
|
| Rate for Payer: Nomi Health Commercial |
$735.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.05
|
| Rate for Payer: PACE Senior Care Partners |
$213.13
|
| Rate for Payer: PACE SWMI |
$224.35
|
| Rate for Payer: PHP Commercial |
$762.79
|
| Rate for Payer: PHP Medicare Advantage |
$224.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$780.74
|
| Rate for Payer: Priority Health Medicare |
$226.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$624.59
|
| Rate for Payer: Railroad Medicare Medicare |
$224.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$789.71
|
| Rate for Payer: UHC Core |
$749.33
|
| Rate for Payer: UHC Exchange |
$224.35
|
| Rate for Payer: UHC Medicaid |
$158.21
|
| Rate for Payer: UHC Medicare Advantage |
$224.35
|
| Rate for Payer: UHCCP Medicaid |
$158.21
|
| Rate for Payer: VA VA |
$224.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$8.98
|
|
|
Service Code
|
NDC 68084015811
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.58 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna Commercial |
$7.63
|
| Rate for Payer: Aetna Medicare |
$2.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
| Rate for Payer: BCBS Complete |
$1.66
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$7.38
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$7.18
|
| Rate for Payer: Cofinity Commercial |
$7.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$8.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.74
|
| Rate for Payer: Mclaren Medicaid |
$1.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Meridian Medicaid |
$1.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.63
|
| Rate for Payer: Nomi Health Commercial |
$7.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.74
|
| Rate for Payer: PACE Senior Care Partners |
$2.13
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$7.63
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.81
|
| Rate for Payer: Priority Health Medicare |
$2.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.25
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.90
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: UHC Exchange |
$2.25
|
| Rate for Payer: UHC Medicaid |
$1.58
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$1.58
|
| Rate for Payer: VA VA |
$2.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.74
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
OP
|
$11.68
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: Aetna Medicare |
$3.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.65
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.60
|
| Rate for Payer: BCN Commercial |
$9.60
|
| Rate for Payer: BCN Medicare Advantage |
$2.92
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Mclaren Medicaid |
$2.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.07
|
| Rate for Payer: Meridian Medicaid |
$2.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PACE Senior Care Partners |
$2.77
|
| Rate for Payer: PACE SWMI |
$2.92
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$2.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Medicare |
$2.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: UHC Exchange |
$2.92
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHC Medicare Advantage |
$2.92
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$2.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
IP
|
$11.68
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: BCBS Trust/PPO |
$9.65
|
| Rate for Payer: BCN Commercial |
$9.65
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
|
MORPHINE VARIABLE DOSE
|
Facility
|
OP
|
$11.68
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
150710
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: Aetna Medicare |
$3.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.65
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$2.92
|
| Rate for Payer: BCBS Trust/PPO |
$9.60
|
| Rate for Payer: BCN Commercial |
$9.60
|
| Rate for Payer: BCN Medicare Advantage |
$2.92
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.92
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Mclaren Medicaid |
$2.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.07
|
| Rate for Payer: Meridian Medicaid |
$2.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: Nomi Health Commercial |
$9.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.76
|
| Rate for Payer: PACE Senior Care Partners |
$2.77
|
| Rate for Payer: PACE SWMI |
$2.92
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: PHP Medicare Advantage |
$2.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.16
|
| Rate for Payer: Priority Health Medicare |
$2.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.13
|
| Rate for Payer: Railroad Medicare Medicare |
$2.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.28
|
| Rate for Payer: UHC Core |
$9.75
|
| Rate for Payer: UHC Exchange |
$2.92
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHC Medicare Advantage |
$2.92
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: VA VA |
$2.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
