|
MORPHINE 100MG/100ML AVERAGE PCA IV SOLUTION
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
190319
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: BCBS Trust/PPO |
$66.12
|
| Rate for Payer: BCN Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 100MG/100ML PCA IV SOLUTION
|
Facility
|
IP
|
$33.50
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
150918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.78 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: BCBS Trust/PPO |
$27.35
|
| Rate for Payer: BCBS Trust/PPO |
$66.12
|
| Rate for Payer: BCN Commercial |
$25.89
|
| Rate for Payer: BCN Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$27.47
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.78
|
| Rate for Payer: Priority Health HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health HMO/PPO |
$29.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$27.97
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 100MG/100ML PCA IV SOLUTION
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
150918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$21.06
|
| Rate for Payer: Aetna Medicare |
$8.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.47
|
| Rate for Payer: BCBS Complete |
$13.40
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$8.38
|
| Rate for Payer: BCBS MAPPO |
$20.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.59
|
| Rate for Payer: BCBS Trust/PPO |
$27.54
|
| Rate for Payer: BCN Commercial |
$62.98
|
| Rate for Payer: BCN Commercial |
$26.05
|
| Rate for Payer: BCN Medicare Advantage |
$20.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.38
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: Nomi Health Commercial |
$27.47
|
| Rate for Payer: PACE Senior Care Partners |
$19.24
|
| Rate for Payer: PACE Senior Care Partners |
$7.96
|
| Rate for Payer: PACE SWMI |
$20.25
|
| Rate for Payer: PACE SWMI |
$8.38
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Medicare Advantage |
$8.38
|
| Rate for Payer: PHP Medicare Advantage |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.78
|
| Rate for Payer: Priority Health HMO/PPO |
$29.14
|
| Rate for Payer: Priority Health HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Medicare |
$20.45
|
| Rate for Payer: Priority Health Medicare |
$8.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.38
|
| Rate for Payer: Railroad Medicare Medicare |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: UHC Core |
$27.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.38
|
| Rate for Payer: UHC Exchange |
$8.38
|
| Rate for Payer: UHC Exchange |
$20.25
|
| Rate for Payer: UHC Medicare Advantage |
$8.38
|
| Rate for Payer: UHC Medicare Advantage |
$20.25
|
| Rate for Payer: VA VA |
$8.38
|
| Rate for Payer: VA VA |
$20.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 100MG/100ML TOLERANT PCA IV SOLUTION
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
190325
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.24 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$21.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.31
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS MAPPO |
$20.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.59
|
| Rate for Payer: BCN Commercial |
$62.98
|
| Rate for Payer: BCN Medicare Advantage |
$20.25
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: PACE Senior Care Partners |
$19.24
|
| Rate for Payer: PACE SWMI |
$20.25
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: PHP Medicare Advantage |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Medicare |
$20.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.27
|
| Rate for Payer: Railroad Medicare Medicare |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.25
|
| Rate for Payer: UHC Exchange |
$20.25
|
| Rate for Payer: UHC Medicare Advantage |
$20.25
|
| Rate for Payer: VA VA |
$20.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 100MG/100ML TOLERANT PCA IV SOLUTION
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
190325
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: BCBS Trust/PPO |
$66.12
|
| Rate for Payer: BCN Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.47
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
27390
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna Commercial |
$14.85
|
| Rate for Payer: BCBS Trust/PPO |
$14.26
|
| Rate for Payer: BCN Commercial |
$13.50
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Commercial |
$15.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$15.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.85
|
| Rate for Payer: Nomi Health Commercial |
$14.33
|
| Rate for Payer: PHP Commercial |
$14.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.36
|
| Rate for Payer: Priority Health HMO/PPO |
$15.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.37
|
| Rate for Payer: UHC Core |
$14.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.10
|
|
|
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.47
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
27390
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna Commercial |
$14.85
|
| Rate for Payer: Aetna Medicare |
$4.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.46
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS MAPPO |
$4.37
|
| Rate for Payer: BCBS Trust/PPO |
$14.36
|
| Rate for Payer: BCN Commercial |
$13.58
|
| Rate for Payer: BCN Medicare Advantage |
$4.37
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Commercial |
$15.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.37
|
| Rate for Payer: Healthscope Commercial |
$15.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.85
|
| Rate for Payer: Nomi Health Commercial |
$14.33
|
| Rate for Payer: PACE Senior Care Partners |
$4.15
|
| Rate for Payer: PACE SWMI |
$4.37
|
| Rate for Payer: PHP Commercial |
$14.85
|
| Rate for Payer: PHP Medicare Advantage |
$4.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.36
|
| Rate for Payer: Priority Health HMO/PPO |
$15.20
|
| Rate for Payer: Priority Health Medicare |
$4.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.70
|
| Rate for Payer: Railroad Medicare Medicare |
$4.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.37
|
| Rate for Payer: UHC Core |
$14.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.37
|
| Rate for Payer: UHC Exchange |
$4.37
|
| Rate for Payer: UHC Medicare Advantage |
$4.37
|
| Rate for Payer: VA VA |
$4.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.10
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$511.00
|
|
|
Service Code
|
NDC 60687061701
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$332.15 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna Commercial |
$434.35
|
| Rate for Payer: BCBS Trust/PPO |
$417.13
|
| Rate for Payer: BCN Commercial |
$394.90
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$439.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.80
|
| Rate for Payer: Healthscope Commercial |
$459.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.35
|
| Rate for Payer: Nomi Health Commercial |
$419.02
|
| Rate for Payer: PHP Commercial |
$434.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.15
|
| Rate for Payer: Priority Health HMO/PPO |
$444.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.68
|
| Rate for Payer: UHC Core |
$426.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.25
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$5.11
|
|
|
Service Code
|
NDC 60687061711
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$4.60 |
| Rate for Payer: Aetna Commercial |
$4.34
|
| Rate for Payer: Aetna Medicare |
$1.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.60
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS MAPPO |
$1.28
|
| Rate for Payer: BCBS Trust/PPO |
$4.20
|
| Rate for Payer: BCN Commercial |
$3.97
|
| Rate for Payer: BCN Medicare Advantage |
$1.28
|
| Rate for Payer: Cash Price |
$4.09
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.28
|
| Rate for Payer: Healthscope Commercial |
$4.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.34
|
| Rate for Payer: Nomi Health Commercial |
$4.19
|
| Rate for Payer: PACE Senior Care Partners |
$1.21
|
| Rate for Payer: PACE SWMI |
$1.28
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: PHP Medicare Advantage |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.32
|
| Rate for Payer: Priority Health HMO/PPO |
$4.45
|
| Rate for Payer: Priority Health Medicare |
$1.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.50
|
| Rate for Payer: UHC Core |
$4.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$1.28
|
| Rate for Payer: UHC Exchange |
$1.28
|
| Rate for Payer: UHC Medicare Advantage |
$1.28
|
| Rate for Payer: VA VA |
$1.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.83
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$511.00
|
|
|
Service Code
|
NDC 60687061701
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$121.36 |
| Max. Negotiated Rate |
$459.90 |
| Rate for Payer: Aetna Commercial |
$434.35
|
| Rate for Payer: Aetna Medicare |
$132.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$159.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$159.69
|
| Rate for Payer: BCBS Complete |
$204.40
|
| Rate for Payer: BCBS MAPPO |
$127.75
|
| Rate for Payer: BCBS Trust/PPO |
$420.09
|
| Rate for Payer: BCN Commercial |
$397.30
|
| Rate for Payer: BCN Medicare Advantage |
$127.75
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$439.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.75
|
| Rate for Payer: Healthscope Commercial |
$459.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$383.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$146.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.35
|
| Rate for Payer: Nomi Health Commercial |
$419.02
|
| Rate for Payer: PACE Senior Care Partners |
$121.36
|
| Rate for Payer: PACE SWMI |
$127.75
|
| Rate for Payer: PHP Commercial |
$434.35
|
| Rate for Payer: PHP Medicare Advantage |
$127.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.15
|
| Rate for Payer: Priority Health HMO/PPO |
$444.57
|
| Rate for Payer: Priority Health Medicare |
$129.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$342.37
|
| Rate for Payer: Railroad Medicare Medicare |
$127.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$449.68
|
| Rate for Payer: UHC Core |
$426.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.75
|
| Rate for Payer: UHC Exchange |
$127.75
|
| Rate for Payer: UHC Medicare Advantage |
$127.75
|
| Rate for Payer: VA VA |
$127.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$383.25
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$123.38
|
|
|
Service Code
|
NDC 00054023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: BCBS Trust/PPO |
$100.72
|
| Rate for Payer: BCN Commercial |
$95.35
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$106.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$111.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Nomi Health Commercial |
$101.17
|
| Rate for Payer: PHP Commercial |
$104.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.20
|
| Rate for Payer: Priority Health HMO/PPO |
$107.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.57
|
| Rate for Payer: UHC Core |
$103.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.54
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$5.11
|
|
|
Service Code
|
NDC 60687061711
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$4.60 |
| Rate for Payer: Aetna Commercial |
$4.34
|
| Rate for Payer: BCBS Trust/PPO |
$4.17
|
| Rate for Payer: BCN Commercial |
$3.95
|
| Rate for Payer: Cash Price |
$4.09
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.09
|
| Rate for Payer: Healthscope Commercial |
$4.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.34
|
| Rate for Payer: Nomi Health Commercial |
$4.19
|
| Rate for Payer: PHP Commercial |
$4.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.32
|
| Rate for Payer: Priority Health HMO/PPO |
$4.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.50
|
| Rate for Payer: UHC Core |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.83
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$123.38
|
|
|
Service Code
|
NDC 00054023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: Aetna Medicare |
$32.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.56
|
| Rate for Payer: BCBS Complete |
$49.35
|
| Rate for Payer: BCBS MAPPO |
$30.84
|
| Rate for Payer: BCBS Trust/PPO |
$101.43
|
| Rate for Payer: BCN Commercial |
$95.93
|
| Rate for Payer: BCN Medicare Advantage |
$30.84
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$106.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.84
|
| Rate for Payer: Healthscope Commercial |
$111.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Nomi Health Commercial |
$101.17
|
| Rate for Payer: PACE Senior Care Partners |
$29.30
|
| Rate for Payer: PACE SWMI |
$30.84
|
| Rate for Payer: PHP Commercial |
$104.87
|
| Rate for Payer: PHP Medicare Advantage |
$30.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.20
|
| Rate for Payer: Priority Health HMO/PPO |
$107.34
|
| Rate for Payer: Priority Health Medicare |
$31.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.66
|
| Rate for Payer: Railroad Medicare Medicare |
$30.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.57
|
| Rate for Payer: UHC Core |
$103.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.84
|
| Rate for Payer: UHC Exchange |
$30.84
|
| Rate for Payer: UHC Medicare Advantage |
$30.84
|
| Rate for Payer: VA VA |
$30.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.54
|
|
|
MORPHINE 1 MG/ML IV INFUSION (IV PREMIX) 100 ML
|
Facility
|
IP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
151077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.78 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: BCBS Trust/PPO |
$27.35
|
| Rate for Payer: BCN Commercial |
$25.89
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Nomi Health Commercial |
$27.47
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.78
|
| Rate for Payer: Priority Health HMO/PPO |
$29.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.48
|
| Rate for Payer: UHC Core |
$27.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML IV INFUSION (IV PREMIX) 100 ML
|
Facility
|
OP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
151077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$8.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.47
|
| Rate for Payer: BCBS Complete |
$13.40
|
| Rate for Payer: BCBS MAPPO |
$8.38
|
| Rate for Payer: BCBS Trust/PPO |
$27.54
|
| Rate for Payer: BCN Commercial |
$26.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.38
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.38
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: Nomi Health Commercial |
$27.47
|
| Rate for Payer: PACE Senior Care Partners |
$7.96
|
| Rate for Payer: PACE SWMI |
$8.38
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Medicare Advantage |
$8.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.78
|
| Rate for Payer: Priority Health HMO/PPO |
$29.14
|
| Rate for Payer: Priority Health Medicare |
$8.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.44
|
| Rate for Payer: Railroad Medicare Medicare |
$8.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.48
|
| Rate for Payer: UHC Core |
$27.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.38
|
| Rate for Payer: UHC Exchange |
$8.38
|
| Rate for Payer: UHC Medicare Advantage |
$8.38
|
| Rate for Payer: VA VA |
$8.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$15.31
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$13.78 |
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna Medicare |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.78
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS MAPPO |
$3.83
|
| Rate for Payer: BCBS Trust/PPO |
$12.59
|
| Rate for Payer: BCN Commercial |
$11.90
|
| Rate for Payer: BCN Medicare Advantage |
$3.83
|
| Rate for Payer: Cash Price |
$12.25
|
| Rate for Payer: Cofinity Commercial |
$13.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.83
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: PACE Senior Care Partners |
$3.64
|
| Rate for Payer: PACE SWMI |
$3.83
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health HMO/PPO |
$13.32
|
| Rate for Payer: Priority Health Medicare |
$3.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.47
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.83
|
| Rate for Payer: UHC Exchange |
$3.83
|
| Rate for Payer: UHC Medicare Advantage |
$3.83
|
| Rate for Payer: VA VA |
$3.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$26.76
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$24.08 |
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Medicare |
$6.96
|
| Rate for Payer: Aetna Medicare |
$4.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.86
|
| Rate for Payer: BCBS Complete |
$7.50
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS MAPPO |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$6.69
|
| Rate for Payer: BCBS Trust/PPO |
$22.00
|
| Rate for Payer: BCBS Trust/PPO |
$15.41
|
| Rate for Payer: BCN Commercial |
$20.81
|
| Rate for Payer: BCN Commercial |
$14.58
|
| Rate for Payer: BCN Medicare Advantage |
$6.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.69
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.69
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Nomi Health Commercial |
$15.38
|
| Rate for Payer: PACE Senior Care Partners |
$6.36
|
| Rate for Payer: PACE Senior Care Partners |
$4.45
|
| Rate for Payer: PACE SWMI |
$6.69
|
| Rate for Payer: PACE SWMI |
$4.69
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$15.94
|
| Rate for Payer: PHP Medicare Advantage |
$4.69
|
| Rate for Payer: PHP Medicare Advantage |
$6.69
|
| 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 HMO/PPO |
$16.31
|
| Rate for Payer: Priority Health HMO/PPO |
$23.28
|
| Rate for Payer: Priority Health Medicare |
$6.76
|
| Rate for Payer: Priority Health Medicare |
$4.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: Railroad Medicare Medicare |
$4.69
|
| Rate for Payer: Railroad Medicare Medicare |
$6.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.55
|
| Rate for Payer: UHC Core |
$22.34
|
| Rate for Payer: UHC Core |
$15.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.69
|
| Rate for Payer: UHC Exchange |
$4.69
|
| Rate for Payer: UHC Exchange |
$6.69
|
| Rate for Payer: UHC Medicare Advantage |
$4.69
|
| Rate for Payer: UHC Medicare Advantage |
$6.69
|
| Rate for Payer: VA VA |
$4.69
|
| Rate for Payer: VA VA |
$6.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$15.31
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.95 |
| Max. Negotiated Rate |
$13.78 |
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$12.50
|
| Rate for Payer: BCN Commercial |
$11.83
|
| Rate for Payer: Cash Price |
$12.25
|
| Rate for Payer: Cofinity Commercial |
$13.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: Nomi Health Commercial |
$12.55
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health HMO/PPO |
$13.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.47
|
| Rate for Payer: UHC Core |
$12.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$16.88 |
| Rate for Payer: Aetna Commercial |
$15.94
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCBS Trust/PPO |
$21.84
|
| Rate for Payer: BCN Commercial |
$14.49
|
| Rate for Payer: BCN Commercial |
$20.68
|
| Rate for Payer: Cash Price |
$15.00
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Commercial |
$16.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.00
|
| Rate for Payer: Healthscope Commercial |
$16.88
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: Nomi Health Commercial |
$15.38
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| 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 HMO/PPO |
$23.28
|
| Rate for Payer: Priority Health HMO/PPO |
$16.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.55
|
| Rate for Payer: UHC Core |
$15.66
|
| Rate for Payer: UHC Core |
$22.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
|
|
MORPHINE 4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$30.64
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
186563
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.92 |
| Max. Negotiated Rate |
$27.58 |
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: BCBS Trust/PPO |
$25.01
|
| Rate for Payer: BCN Commercial |
$23.68
|
| Rate for Payer: Cash Price |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$26.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.51
|
| Rate for Payer: Healthscope Commercial |
$27.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.92
|
| Rate for Payer: Priority Health HMO/PPO |
$26.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.96
|
| Rate for Payer: UHC Core |
$25.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.98
|
|
|
MORPHINE 4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$30.64
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
186563
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$27.58 |
| Rate for Payer: Aetna Commercial |
$26.04
|
| Rate for Payer: Aetna Medicare |
$7.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.58
|
| Rate for Payer: BCBS Complete |
$12.26
|
| Rate for Payer: BCBS MAPPO |
$7.66
|
| Rate for Payer: BCBS Trust/PPO |
$25.19
|
| Rate for Payer: BCN Commercial |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.66
|
| Rate for Payer: Cash Price |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$26.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.66
|
| Rate for Payer: Healthscope Commercial |
$27.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.04
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: PACE Senior Care Partners |
$7.28
|
| Rate for Payer: PACE SWMI |
$7.66
|
| Rate for Payer: PHP Commercial |
$26.04
|
| Rate for Payer: PHP Medicare Advantage |
$7.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.92
|
| Rate for Payer: Priority Health HMO/PPO |
$26.66
|
| Rate for Payer: Priority Health Medicare |
$7.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.53
|
| Rate for Payer: Railroad Medicare Medicare |
$7.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.96
|
| Rate for Payer: UHC Core |
$25.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.66
|
| Rate for Payer: UHC Exchange |
$7.66
|
| Rate for Payer: UHC Medicare Advantage |
$7.66
|
| Rate for Payer: VA VA |
$7.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.98
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$16.20
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$14.58 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: Aetna Medicare |
$6.96
|
| Rate for Payer: Aetna Medicare |
$4.21
|
| Rate for Payer: Aetna Medicare |
$5.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.36
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS MAPPO |
$6.69
|
| Rate for Payer: BCBS MAPPO |
$4.05
|
| Rate for Payer: BCBS MAPPO |
$5.71
|
| Rate for Payer: BCBS Trust/PPO |
$18.78
|
| Rate for Payer: BCBS Trust/PPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$22.00
|
| Rate for Payer: BCN Commercial |
$17.77
|
| Rate for Payer: BCN Commercial |
$20.81
|
| Rate for Payer: BCN Commercial |
$12.60
|
| Rate for Payer: BCN Medicare Advantage |
$4.05
|
| Rate for Payer: BCN Medicare Advantage |
$5.71
|
| Rate for Payer: BCN Medicare Advantage |
$6.69
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Commercial |
$19.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.05
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Healthscope Commercial |
$14.58
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.77
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Nomi Health Commercial |
$13.28
|
| Rate for Payer: Nomi Health Commercial |
$18.74
|
| Rate for Payer: PACE Senior Care Partners |
$6.36
|
| Rate for Payer: PACE Senior Care Partners |
$3.85
|
| Rate for Payer: PACE Senior Care Partners |
$5.43
|
| Rate for Payer: PACE SWMI |
$5.71
|
| Rate for Payer: PACE SWMI |
$4.05
|
| Rate for Payer: PACE SWMI |
$6.69
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$19.42
|
| Rate for Payer: PHP Commercial |
$13.77
|
| Rate for Payer: PHP Medicare Advantage |
$5.71
|
| Rate for Payer: PHP Medicare Advantage |
$6.69
|
| Rate for Payer: PHP Medicare Advantage |
$4.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO |
$23.28
|
| Rate for Payer: Priority Health HMO/PPO |
$14.09
|
| Rate for Payer: Priority Health HMO/PPO |
$19.88
|
| Rate for Payer: Priority Health Medicare |
$4.09
|
| Rate for Payer: Priority Health Medicare |
$6.76
|
| Rate for Payer: Priority Health Medicare |
$5.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.85
|
| Rate for Payer: Railroad Medicare Medicare |
$5.71
|
| Rate for Payer: Railroad Medicare Medicare |
$6.69
|
| Rate for Payer: Railroad Medicare Medicare |
$4.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.26
|
| Rate for Payer: UHC Core |
$22.34
|
| Rate for Payer: UHC Core |
$19.08
|
| Rate for Payer: UHC Core |
$13.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.71
|
| Rate for Payer: UHC Exchange |
$5.71
|
| Rate for Payer: UHC Exchange |
$4.05
|
| Rate for Payer: UHC Exchange |
$6.69
|
| Rate for Payer: UHC Medicare Advantage |
$4.05
|
| Rate for Payer: UHC Medicare Advantage |
$5.71
|
| Rate for Payer: UHC Medicare Advantage |
$6.69
|
| Rate for Payer: VA VA |
$5.71
|
| Rate for Payer: VA VA |
$6.69
|
| Rate for Payer: VA VA |
$4.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.14
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$25.81
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna Commercial |
$13.45
|
| Rate for Payer: Aetna Medicare |
$6.71
|
| Rate for Payer: Aetna Medicare |
$4.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS Complete |
$10.32
|
| Rate for Payer: BCBS MAPPO |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.45
|
| Rate for Payer: BCBS Trust/PPO |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$13.01
|
| Rate for Payer: BCN Commercial |
$20.07
|
| Rate for Payer: BCN Commercial |
$12.30
|
| Rate for Payer: BCN Medicare Advantage |
$6.45
|
| Rate for Payer: BCN Medicare Advantage |
$3.96
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cash Price |
$12.66
|
| Rate for Payer: Cofinity Commercial |
$13.61
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.45
|
| Rate for Payer: Healthscope Commercial |
$14.24
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.45
|
| Rate for Payer: Nomi Health Commercial |
$21.16
|
| Rate for Payer: Nomi Health Commercial |
$12.97
|
| Rate for Payer: PACE Senior Care Partners |
$6.13
|
| Rate for Payer: PACE Senior Care Partners |
$3.76
|
| Rate for Payer: PACE SWMI |
$6.45
|
| Rate for Payer: PACE SWMI |
$3.96
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$13.45
|
| Rate for Payer: PHP Medicare Advantage |
$3.96
|
| Rate for Payer: PHP Medicare Advantage |
$6.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.28
|
| Rate for Payer: Priority Health HMO/PPO |
$13.76
|
| Rate for Payer: Priority Health HMO/PPO |
$22.45
|
| Rate for Payer: Priority Health Medicare |
$6.52
|
| Rate for Payer: Priority Health Medicare |
$3.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.60
|
| Rate for Payer: Railroad Medicare Medicare |
$3.96
|
| Rate for Payer: Railroad Medicare Medicare |
$6.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.71
|
| Rate for Payer: UHC Core |
$21.55
|
| Rate for Payer: UHC Core |
$13.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.96
|
| Rate for Payer: UHC Exchange |
$3.96
|
| Rate for Payer: UHC Exchange |
$6.45
|
| Rate for Payer: UHC Medicare Advantage |
$3.96
|
| Rate for Payer: UHC Medicare Advantage |
$6.45
|
| Rate for Payer: VA VA |
$3.96
|
| Rate for Payer: VA VA |
$6.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.86
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$15.82
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.28 |
| Max. Negotiated Rate |
$14.24 |
| Rate for Payer: Aetna Commercial |
$13.45
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: BCBS Trust/PPO |
$12.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.07
|
| Rate for Payer: BCN Commercial |
$12.23
|
| Rate for Payer: BCN Commercial |
$19.95
|
| Rate for Payer: Cash Price |
$12.66
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Cofinity Commercial |
$13.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.66
|
| Rate for Payer: Healthscope Commercial |
$14.24
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: Nomi Health Commercial |
$12.97
|
| Rate for Payer: Nomi Health Commercial |
$21.16
|
| Rate for Payer: PHP Commercial |
$13.45
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.28
|
| Rate for Payer: Priority Health HMO/PPO |
$22.45
|
| Rate for Payer: Priority Health HMO/PPO |
$13.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.71
|
| Rate for Payer: UHC Core |
$13.21
|
| Rate for Payer: UHC Core |
$21.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$16.20
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.53 |
| Max. Negotiated Rate |
$14.58 |
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: BCBS Trust/PPO |
$18.65
|
| Rate for Payer: BCBS Trust/PPO |
$13.22
|
| Rate for Payer: BCBS Trust/PPO |
$21.84
|
| Rate for Payer: BCN Commercial |
$17.66
|
| Rate for Payer: BCN Commercial |
$12.52
|
| Rate for Payer: BCN Commercial |
$20.68
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Commercial |
$19.65
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Healthscope Commercial |
$14.58
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: Nomi Health Commercial |
$13.28
|
| Rate for Payer: Nomi Health Commercial |
$18.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$19.42
|
| Rate for Payer: PHP Commercial |
$13.77
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO |
$23.28
|
| Rate for Payer: Priority Health HMO/PPO |
$19.88
|
| Rate for Payer: Priority Health HMO/PPO |
$14.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.26
|
| Rate for Payer: UHC Core |
$13.53
|
| Rate for Payer: UHC Core |
$22.34
|
| Rate for Payer: UHC Core |
$19.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.14
|
|
