|
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 |
$14.74 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.78
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.78
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.45
|
| Rate for Payer: Priority Health SBD |
$21.10
|
| Rate for Payer: UMR Bronson Commercial |
$14.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML PEDIATRIC PCA IV SOLUTION
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300298
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.64 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$56.70
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.85
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.70
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UMR Bronson Commercial |
$35.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 20 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$261.10
|
|
|
Service Code
|
NDC 0574-7114-12
|
| Hospital Charge Code |
5181
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$114.88 |
| Max. Negotiated Rate |
$234.99 |
| Rate for Payer: Aetna American Axle |
$169.72
|
| Rate for Payer: Aetna Commercial |
$221.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.72
|
| Rate for Payer: Cash Price |
$208.88
|
| Rate for Payer: Cofinity Commercial |
$182.77
|
| Rate for Payer: Cofinity Commercial |
$224.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.88
|
| Rate for Payer: Healthscope Commercial |
$234.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$221.94
|
| Rate for Payer: PHP Commercial |
$221.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.77
|
| Rate for Payer: Priority Health SBD |
$164.49
|
| Rate for Payer: UMR Bronson Commercial |
$114.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.82
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$29.77
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$26.79 |
| Rate for Payer: Aetna American Axle |
$19.35
|
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare |
$7.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.29
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS MAPPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$24.01
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| Rate for Payer: Cash Price |
$23.82
|
| Rate for Payer: Cash Price |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$20.84
|
| Rate for Payer: Cofinity Commercial |
$25.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.43
|
| Rate for Payer: Healthscope Commercial |
$26.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.33
|
| Rate for Payer: Mclaren Medicaid |
$4.07
|
| Rate for Payer: Mclaren Medicare |
$7.43
|
| Rate for Payer: Meridian Medicaid |
$4.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.30
|
| Rate for Payer: PACE Medicare |
$7.06
|
| Rate for Payer: PACE SWMI |
$7.43
|
| Rate for Payer: PHP Commercial |
$25.30
|
| Rate for Payer: PHP Medicare Advantage |
$7.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.76
|
| Rate for Payer: Priority Health Medicare |
$7.43
|
| Rate for Payer: Priority Health Narrow Network |
$16.61
|
| Rate for Payer: Priority Health SBD |
$18.76
|
| Rate for Payer: Railroad Medicare Medicare |
$7.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.43
|
| Rate for Payer: UHC Medicare Advantage |
$7.66
|
| Rate for Payer: UMR Bronson Commercial |
$11.01
|
| Rate for Payer: VA VA |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.33
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$24.78
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$22.30 |
| Rate for Payer: Aetna American Axle |
$16.11
|
| Rate for Payer: Aetna Commercial |
$21.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: BCBS Complete |
$9.91
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$21.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.82
|
| Rate for Payer: Healthscope Commercial |
$22.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.06
|
| Rate for Payer: PHP Commercial |
$21.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.35
|
| Rate for Payer: Priority Health SBD |
$15.61
|
| Rate for Payer: UMR Bronson Commercial |
$9.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.58
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$14.39
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$12.95 |
| Rate for Payer: Aetna American Axle |
$9.35
|
| Rate for Payer: Aetna Commercial |
$12.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.35
|
| Rate for Payer: Cash Price |
$11.51
|
| Rate for Payer: Cofinity Commercial |
$12.38
|
| Rate for Payer: Cofinity Commercial |
$10.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.51
|
| Rate for Payer: Healthscope Commercial |
$12.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.23
|
| Rate for Payer: PHP Commercial |
$12.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.07
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: UMR Bronson Commercial |
$6.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.79
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$24.78
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$22.30 |
| Rate for Payer: Aetna American Axle |
$16.11
|
| Rate for Payer: Aetna Commercial |
$21.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$21.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.82
|
| Rate for Payer: Healthscope Commercial |
$22.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.06
|
| Rate for Payer: PHP Commercial |
$21.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.35
|
| Rate for Payer: Priority Health SBD |
$15.61
|
| Rate for Payer: UMR Bronson Commercial |
$10.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.58
|
|
|
MORPHINE 4 MG/4 ML INJECTION SOLUTION
|
Facility
|
IP
|
$29.79
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$26.81 |
| Rate for Payer: Aetna American Axle |
$19.36
|
| Rate for Payer: Aetna Commercial |
$25.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.36
|
| Rate for Payer: Cash Price |
$23.83
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Cofinity Commercial |
$25.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$26.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.32
|
| Rate for Payer: PHP Commercial |
$25.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.85
|
| Rate for Payer: Priority Health SBD |
$18.77
|
| Rate for Payer: UMR Bronson Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.34
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$36.26
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$32.63 |
| Rate for Payer: Aetna American Axle |
$23.57
|
| Rate for Payer: Aetna American Axle |
$10.04
|
| Rate for Payer: Aetna American Axle |
$16.11
|
| Rate for Payer: Aetna American Axle |
$13.50
|
| Rate for Payer: Aetna Commercial |
$13.13
|
| Rate for Payer: Aetna Commercial |
$30.82
|
| Rate for Payer: Aetna Commercial |
$17.65
|
| Rate for Payer: Aetna Commercial |
$21.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.50
|
| Rate for Payer: Cash Price |
$29.01
|
| Rate for Payer: Cash Price |
$12.36
|
| Rate for Payer: Cash Price |
$16.62
|
| Rate for Payer: Cash Price |
$19.82
|
| Rate for Payer: Cofinity Commercial |
$21.31
|
| Rate for Payer: Cofinity Commercial |
$10.82
|
| Rate for Payer: Cofinity Commercial |
$13.29
|
| Rate for Payer: Cofinity Commercial |
$14.54
|
| Rate for Payer: Cofinity Commercial |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$25.38
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.62
|
| Rate for Payer: Healthscope Commercial |
$22.30
|
| Rate for Payer: Healthscope Commercial |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$13.90
|
| Rate for Payer: Healthscope Commercial |
$18.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.06
|
| Rate for Payer: PHP Commercial |
$17.65
|
| Rate for Payer: PHP Commercial |
$30.82
|
| Rate for Payer: PHP Commercial |
$21.06
|
| Rate for Payer: PHP Commercial |
$13.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.38
|
| Rate for Payer: Priority Health SBD |
$13.09
|
| Rate for Payer: Priority Health SBD |
$15.61
|
| Rate for Payer: Priority Health SBD |
$9.73
|
| Rate for Payer: Priority Health SBD |
$22.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.14
|
| Rate for Payer: UMR Bronson Commercial |
$6.80
|
| Rate for Payer: UMR Bronson Commercial |
$10.90
|
| Rate for Payer: UMR Bronson Commercial |
$15.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$25.81
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna American Axle |
$16.78
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.78
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cofinity Commercial |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.94
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.07
|
| Rate for Payer: Priority Health SBD |
$16.26
|
| Rate for Payer: UMR Bronson Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
|
|
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$123.05
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
109061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.14 |
| Max. Negotiated Rate |
$110.74 |
| Rate for Payer: Aetna American Axle |
$79.98
|
| Rate for Payer: Aetna American Axle |
$37.66
|
| Rate for Payer: Aetna Commercial |
$49.25
|
| Rate for Payer: Aetna Commercial |
$104.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cofinity Commercial |
$105.82
|
| Rate for Payer: Cofinity Commercial |
$86.14
|
| Rate for Payer: Cofinity Commercial |
$40.56
|
| Rate for Payer: Cofinity Commercial |
$49.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
| Rate for Payer: Healthscope Commercial |
$52.15
|
| Rate for Payer: Healthscope Commercial |
$110.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$104.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.25
|
| Rate for Payer: PHP Commercial |
$104.59
|
| Rate for Payer: PHP Commercial |
$49.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.56
|
| Rate for Payer: Priority Health SBD |
$77.52
|
| Rate for Payer: Priority Health SBD |
$36.50
|
| Rate for Payer: UMR Bronson Commercial |
$25.49
|
| Rate for Payer: UMR Bronson Commercial |
$54.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.46
|
|
|
MORPHINE 7.5 MG IMMEDIATE RELEASE CUSTOM TABLET
|
Facility
|
IP
|
$2.28
|
|
|
Service Code
|
NDC 9900-0011-30
|
| Hospital Charge Code |
300182
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Aetna American Axle |
$1.48
|
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.48
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$2.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1.94
|
| Rate for Payer: PHP Commercial |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.60
|
| Rate for Payer: Priority Health SBD |
$1.44
|
| Rate for Payer: UMR Bronson Commercial |
$1.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.71
|
|
|
MORPHINE (BULK) 100 % POWDER
|
Facility
|
IP
|
$108.18
|
|
|
Service Code
|
NDC 0406-1521-53
|
| Hospital Charge Code |
5184
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$47.60 |
| Max. Negotiated Rate |
$97.36 |
| Rate for Payer: Aetna American Axle |
$70.32
|
| Rate for Payer: Aetna Commercial |
$91.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.32
|
| Rate for Payer: Cash Price |
$86.54
|
| Rate for Payer: Cofinity Commercial |
$75.73
|
| Rate for Payer: Cofinity Commercial |
$93.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.54
|
| Rate for Payer: Healthscope Commercial |
$97.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.95
|
| Rate for Payer: PHP Commercial |
$91.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.73
|
| Rate for Payer: Priority Health SBD |
$68.15
|
| Rate for Payer: UMR Bronson Commercial |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.14
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$10.74
|
|
|
Service Code
|
NDC 68094-045-58
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$9.67 |
| Rate for Payer: Aetna American Axle |
$6.98
|
| Rate for Payer: Aetna Commercial |
$9.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.98
|
| Rate for Payer: Cash Price |
$8.59
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Cofinity Commercial |
$9.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.59
|
| Rate for Payer: Healthscope Commercial |
$9.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.13
|
| Rate for Payer: PHP Commercial |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.52
|
| Rate for Payer: Priority Health SBD |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$4.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.06
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$10.74
|
|
|
Service Code
|
NDC 68094-045-01
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$9.67 |
| Rate for Payer: Aetna American Axle |
$6.98
|
| Rate for Payer: Aetna Commercial |
$9.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.98
|
| Rate for Payer: Cash Price |
$8.59
|
| Rate for Payer: Cofinity Commercial |
$7.52
|
| Rate for Payer: Cofinity Commercial |
$9.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.59
|
| Rate for Payer: Healthscope Commercial |
$9.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.13
|
| Rate for Payer: PHP Commercial |
$9.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.52
|
| Rate for Payer: Priority Health SBD |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$4.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.06
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.70
|
|
|
Service Code
|
NDC 68094-056-58
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: Aetna American Axle |
$7.60
|
| Rate for Payer: Aetna Commercial |
$9.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.60
|
| Rate for Payer: Cash Price |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$10.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.94
|
| Rate for Payer: PHP Commercial |
$9.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.19
|
| Rate for Payer: Priority Health SBD |
$7.37
|
| Rate for Payer: UMR Bronson Commercial |
$5.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.78
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.70
|
|
|
Service Code
|
NDC 68094-056-01
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$10.53 |
| Rate for Payer: Aetna American Axle |
$7.60
|
| Rate for Payer: Aetna Commercial |
$9.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.60
|
| Rate for Payer: Cash Price |
$9.36
|
| Rate for Payer: Cofinity Commercial |
$10.06
|
| Rate for Payer: Cofinity Commercial |
$8.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.36
|
| Rate for Payer: Healthscope Commercial |
$10.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.94
|
| Rate for Payer: PHP Commercial |
$9.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.19
|
| Rate for Payer: Priority Health SBD |
$7.37
|
| Rate for Payer: UMR Bronson Commercial |
$5.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.78
|
|
|
MORPHINE ER 100 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$1,155.57
|
|
|
Service Code
|
NDC 0904-6560-61
|
| Hospital Charge Code |
20919
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$508.45 |
| Max. Negotiated Rate |
$1,040.01 |
| Rate for Payer: Aetna American Axle |
$751.12
|
| Rate for Payer: Aetna Commercial |
$982.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$751.12
|
| Rate for Payer: Cash Price |
$924.46
|
| Rate for Payer: Cofinity Commercial |
$808.90
|
| Rate for Payer: Cofinity Commercial |
$993.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$924.46
|
| Rate for Payer: Healthscope Commercial |
$1,040.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$808.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$866.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$982.23
|
| Rate for Payer: PHP Commercial |
$982.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$808.90
|
| Rate for Payer: Priority Health SBD |
$728.01
|
| Rate for Payer: UMR Bronson Commercial |
$508.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$866.68
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$545.30
|
|
|
Service Code
|
NDC 0406-8315-62
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$239.93 |
| Max. Negotiated Rate |
$490.77 |
| Rate for Payer: Aetna American Axle |
$354.44
|
| Rate for Payer: Aetna Commercial |
$463.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.44
|
| Rate for Payer: Cash Price |
$436.24
|
| Rate for Payer: Cofinity Commercial |
$381.71
|
| Rate for Payer: Cofinity Commercial |
$468.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.24
|
| Rate for Payer: Healthscope Commercial |
$490.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$408.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$463.50
|
| Rate for Payer: PHP Commercial |
$463.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$381.71
|
| Rate for Payer: Priority Health SBD |
$343.54
|
| Rate for Payer: UMR Bronson Commercial |
$239.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$408.98
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$911.75
|
|
|
Service Code
|
NDC 0904-6557-61
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$401.17 |
| Max. Negotiated Rate |
$820.58 |
| Rate for Payer: Aetna American Axle |
$592.64
|
| Rate for Payer: Aetna Commercial |
$774.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$592.64
|
| Rate for Payer: Cash Price |
$729.40
|
| Rate for Payer: Cofinity Commercial |
$638.22
|
| Rate for Payer: Cofinity Commercial |
$784.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$729.40
|
| Rate for Payer: Healthscope Commercial |
$820.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$638.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$683.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$774.99
|
| Rate for Payer: PHP Commercial |
$774.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$638.22
|
| Rate for Payer: Priority Health SBD |
$574.40
|
| Rate for Payer: UMR Bronson Commercial |
$401.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$683.81
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$346.50
|
|
|
Service Code
|
NDC 42858-801-01
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$152.46 |
| Max. Negotiated Rate |
$311.85 |
| Rate for Payer: Aetna American Axle |
$225.22
|
| Rate for Payer: Aetna Commercial |
$294.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.22
|
| Rate for Payer: Cash Price |
$277.20
|
| Rate for Payer: Cofinity Commercial |
$242.55
|
| Rate for Payer: Cofinity Commercial |
$297.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.20
|
| Rate for Payer: Healthscope Commercial |
$311.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$294.52
|
| Rate for Payer: PHP Commercial |
$294.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.55
|
| Rate for Payer: Priority Health SBD |
$218.30
|
| Rate for Payer: UMR Bronson Commercial |
$152.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.88
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$431.90
|
|
|
Service Code
|
NDC 0406-8315-01
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$190.04 |
| Max. Negotiated Rate |
$388.71 |
| Rate for Payer: Aetna American Axle |
$280.74
|
| Rate for Payer: Aetna Commercial |
$367.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$280.74
|
| Rate for Payer: Cash Price |
$345.52
|
| Rate for Payer: Cofinity Commercial |
$302.33
|
| Rate for Payer: Cofinity Commercial |
$371.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.52
|
| Rate for Payer: Healthscope Commercial |
$388.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$302.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$367.12
|
| Rate for Payer: PHP Commercial |
$367.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.33
|
| Rate for Payer: Priority Health SBD |
$272.10
|
| Rate for Payer: UMR Bronson Commercial |
$190.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.92
|
|
|
MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE 24 HR MULTIPHASE
|
Facility
|
IP
|
$1,662.57
|
|
|
Service Code
|
NDC 0228-3090-11
|
| Hospital Charge Code |
32709
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$731.53 |
| Max. Negotiated Rate |
$1,496.31 |
| Rate for Payer: Aetna American Axle |
$1,080.67
|
| Rate for Payer: Aetna Commercial |
$1,413.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,080.67
|
| Rate for Payer: Cash Price |
$1,330.06
|
| Rate for Payer: Cofinity Commercial |
$1,163.80
|
| Rate for Payer: Cofinity Commercial |
$1,429.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,330.06
|
| Rate for Payer: Healthscope Commercial |
$1,496.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,163.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,246.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,413.18
|
| Rate for Payer: PHP Commercial |
$1,413.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,163.80
|
| Rate for Payer: Priority Health SBD |
$1,047.42
|
| Rate for Payer: UMR Bronson Commercial |
$731.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,246.93
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$820.40
|
|
|
Service Code
|
NDC 0406-8330-01
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$360.98 |
| Max. Negotiated Rate |
$738.36 |
| Rate for Payer: Aetna American Axle |
$533.26
|
| Rate for Payer: Aetna Commercial |
$697.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.26
|
| Rate for Payer: Cash Price |
$656.32
|
| Rate for Payer: Cofinity Commercial |
$574.28
|
| Rate for Payer: Cofinity Commercial |
$705.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.32
|
| Rate for Payer: Healthscope Commercial |
$738.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$697.34
|
| Rate for Payer: PHP Commercial |
$697.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.28
|
| Rate for Payer: Priority Health SBD |
$516.85
|
| Rate for Payer: UMR Bronson Commercial |
$360.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.30
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$10.37
|
|
|
Service Code
|
NDC 0406-8330-23
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$9.33 |
| Rate for Payer: Aetna American Axle |
$6.74
|
| Rate for Payer: Aetna Commercial |
$8.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.74
|
| Rate for Payer: Cash Price |
$8.30
|
| Rate for Payer: Cofinity Commercial |
$8.92
|
| Rate for Payer: Cofinity Commercial |
$7.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.30
|
| Rate for Payer: Healthscope Commercial |
$9.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.81
|
| Rate for Payer: PHP Commercial |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.26
|
| Rate for Payer: Priority Health SBD |
$6.53
|
| Rate for Payer: UMR Bronson Commercial |
$4.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.78
|
|
