|
MORPHINE 0.1 MG/ML INJECTION (NICU)
|
Facility
|
IP
|
$22.07
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
500539
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna American Axle |
$14.35
|
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Advantage |
$15.45
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: Priority Health SBD |
$13.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.55
|
|
|
MORPHINE 0.2 MG/ML 1 ML ORAL SOLUTION
|
Facility
|
OP
|
$0.55
|
|
|
Service Code
|
NDC 09900000428
|
| Hospital Charge Code |
165001
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Aetna American Axle |
$0.36
|
| Rate for Payer: Aetna Commercial |
$0.47
|
| Rate for Payer: Aetna Medicare |
$0.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.36
|
| Rate for Payer: BCBS Complete |
$0.22
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cofinity Advantage |
$0.39
|
| Rate for Payer: Cofinity Commercial |
$0.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.44
|
| Rate for Payer: Healthscope Commercial |
$0.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.41
|
| Rate for Payer: PHP Commercial |
$0.47
|
| Rate for Payer: Priority Health SBD |
$0.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.36
|
| Rate for Payer: UHC Core |
$0.29
|
| Rate for Payer: UHC Exchange |
$0.22
|
| Rate for Payer: UMR Bronson Commercial |
$0.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.41
|
|
|
MORPHINE 0.2 MG/ML 1 ML ORAL SOLUTION
|
Facility
|
IP
|
$0.55
|
|
|
Service Code
|
NDC 09900000428
|
| Hospital Charge Code |
165001
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Aetna American Axle |
$0.36
|
| Rate for Payer: Aetna Commercial |
$0.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.36
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cofinity Advantage |
$0.39
|
| Rate for Payer: Cofinity Commercial |
$0.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.44
|
| Rate for Payer: Healthscope Commercial |
$0.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.41
|
| Rate for Payer: PHP Commercial |
$0.47
|
| Rate for Payer: Priority Health SBD |
$0.35
|
| Rate for Payer: UMR Bronson Commercial |
$0.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.41
|
|
|
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 |
$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 Advantage |
$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 Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| 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 100MG/100ML AVERAGE PCA IV SOLUTION
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
190319
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Trust/PPO |
$43.73
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$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: MI Amish Medical Board Commercial |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC Core |
$22.28
|
| Rate for Payer: UHC Exchange |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$29.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 100MG/100ML PCA IV SOLUTION
|
Facility
|
OP
|
$227.49
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
150918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.28 |
| Max. Negotiated Rate |
$204.74 |
| Rate for Payer: Aetna American Axle |
$147.87
|
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$193.37
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$113.75
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Complete |
$91.00
|
| Rate for Payer: BCBS Trust/PPO |
$43.73
|
| Rate for Payer: BCBS Trust/PPO |
$43.73
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: Cash Price |
$181.99
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$181.99
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$159.24
|
| Rate for Payer: Cofinity Advantage |
$56.70
|
| Rate for Payer: Cofinity Commercial |
$195.64
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$204.74
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$181.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.62
|
| Rate for Payer: PHP Commercial |
$193.37
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health SBD |
$143.32
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC Core |
$22.28
|
| Rate for Payer: UHC Core |
$22.28
|
| Rate for Payer: UHC Exchange |
$22.28
|
| Rate for Payer: UHC Exchange |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$84.17
|
| Rate for Payer: UMR Bronson Commercial |
$29.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 100MG/100ML PCA IV SOLUTION
|
Facility
|
IP
|
$227.49
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
150918
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$100.10 |
| Max. Negotiated Rate |
$204.74 |
| Rate for Payer: Aetna American Axle |
$147.87
|
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$193.37
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Cash Price |
$181.99
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$56.70
|
| Rate for Payer: Cofinity Advantage |
$159.24
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Cofinity Commercial |
$195.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$204.74
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$193.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$193.37
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: Priority Health SBD |
$143.32
|
| Rate for Payer: UMR Bronson Commercial |
$100.10
|
| Rate for Payer: UMR Bronson Commercial |
$35.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.62
|
| 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 |
$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 Advantage |
$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 Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| 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 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 |
$22.28 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Trust/PPO |
$43.73
|
| Rate for Payer: BCN Commercial |
$43.73
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$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: MI Amish Medical Board Commercial |
$64.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC Core |
$22.28
|
| Rate for Payer: UHC Exchange |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$29.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$35.44
|
|
|
Service Code
|
NDC 00121495505
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$31.90 |
| Rate for Payer: Aetna American Axle |
$23.04
|
| Rate for Payer: Aetna Commercial |
$30.12
|
| Rate for Payer: Aetna Medicare |
$17.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.04
|
| Rate for Payer: BCBS Complete |
$14.18
|
| Rate for Payer: Cash Price |
$28.35
|
| Rate for Payer: Cofinity Advantage |
$24.81
|
| Rate for Payer: Cofinity Commercial |
$30.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.35
|
| Rate for Payer: Healthscope Commercial |
$31.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.58
|
| Rate for Payer: PHP Commercial |
$30.12
|
| Rate for Payer: Priority Health SBD |
$22.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.04
|
| Rate for Payer: UHC Core |
$18.46
|
| Rate for Payer: UHC Exchange |
$13.93
|
| Rate for Payer: UMR Bronson Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.58
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$376.25
|
|
|
Service Code
|
NDC 00054023763
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$165.55 |
| Max. Negotiated Rate |
$338.62 |
| Rate for Payer: Aetna American Axle |
$244.56
|
| Rate for Payer: Aetna Commercial |
$319.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.56
|
| Rate for Payer: Cash Price |
$301.00
|
| Rate for Payer: Cofinity Advantage |
$263.38
|
| Rate for Payer: Cofinity Commercial |
$323.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.00
|
| Rate for Payer: Healthscope Commercial |
$338.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$263.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$282.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$282.19
|
| Rate for Payer: PHP Commercial |
$319.81
|
| Rate for Payer: Priority Health SBD |
$237.04
|
| Rate for Payer: UMR Bronson Commercial |
$165.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.19
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$35.44
|
|
|
Service Code
|
NDC 00121495505
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$15.59 |
| Max. Negotiated Rate |
$31.90 |
| Rate for Payer: Aetna American Axle |
$23.04
|
| Rate for Payer: Aetna Commercial |
$30.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.04
|
| Rate for Payer: Cash Price |
$28.35
|
| Rate for Payer: Cofinity Advantage |
$24.81
|
| Rate for Payer: Cofinity Commercial |
$30.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.35
|
| Rate for Payer: Healthscope Commercial |
$31.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.58
|
| Rate for Payer: PHP Commercial |
$30.12
|
| Rate for Payer: Priority Health SBD |
$22.33
|
| Rate for Payer: UMR Bronson Commercial |
$15.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.58
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$20.74
|
|
|
Service Code
|
NDC 00121090405
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$18.67 |
| Rate for Payer: Aetna American Axle |
$13.48
|
| Rate for Payer: Aetna Commercial |
$17.63
|
| Rate for Payer: Aetna Medicare |
$10.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.48
|
| Rate for Payer: BCBS Complete |
$8.30
|
| Rate for Payer: Cash Price |
$16.59
|
| Rate for Payer: Cofinity Advantage |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$17.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$18.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: PHP Commercial |
$17.63
|
| Rate for Payer: Priority Health SBD |
$13.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.48
|
| Rate for Payer: UHC Core |
$10.81
|
| Rate for Payer: UHC Exchange |
$8.15
|
| Rate for Payer: UMR Bronson Commercial |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$162.75
|
|
|
Service Code
|
NDC 00054023749
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$60.22 |
| Max. Negotiated Rate |
$146.47 |
| Rate for Payer: Aetna American Axle |
$105.79
|
| Rate for Payer: Aetna Commercial |
$138.34
|
| Rate for Payer: Aetna Medicare |
$81.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.79
|
| Rate for Payer: BCBS Complete |
$65.10
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cofinity Advantage |
$113.92
|
| Rate for Payer: Cofinity Commercial |
$139.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.20
|
| Rate for Payer: Healthscope Commercial |
$146.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.06
|
| Rate for Payer: PHP Commercial |
$138.34
|
| Rate for Payer: Priority Health SBD |
$102.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.79
|
| Rate for Payer: UHC Core |
$84.79
|
| Rate for Payer: UHC Exchange |
$63.96
|
| Rate for Payer: UMR Bronson Commercial |
$60.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.06
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$35.44
|
|
|
Service Code
|
NDC 00121495594
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$31.90 |
| Rate for Payer: Aetna American Axle |
$23.04
|
| Rate for Payer: Aetna Commercial |
$30.12
|
| Rate for Payer: Aetna Medicare |
$17.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.04
|
| Rate for Payer: BCBS Complete |
$14.18
|
| Rate for Payer: Cash Price |
$28.35
|
| Rate for Payer: Cofinity Advantage |
$24.81
|
| Rate for Payer: Cofinity Commercial |
$30.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.35
|
| Rate for Payer: Healthscope Commercial |
$31.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.58
|
| Rate for Payer: PHP Commercial |
$30.12
|
| Rate for Payer: Priority Health SBD |
$22.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.04
|
| Rate for Payer: UHC Core |
$18.46
|
| Rate for Payer: UHC Exchange |
$13.93
|
| Rate for Payer: UMR Bronson Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.58
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$162.75
|
|
|
Service Code
|
NDC 00054023749
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$71.61 |
| Max. Negotiated Rate |
$146.47 |
| Rate for Payer: Aetna American Axle |
$105.79
|
| Rate for Payer: Aetna Commercial |
$138.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.79
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cofinity Advantage |
$113.92
|
| Rate for Payer: Cofinity Commercial |
$139.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.20
|
| Rate for Payer: Healthscope Commercial |
$146.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.06
|
| Rate for Payer: PHP Commercial |
$138.34
|
| Rate for Payer: Priority Health SBD |
$102.53
|
| Rate for Payer: UMR Bronson Commercial |
$71.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.06
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$0.75
|
|
|
Service Code
|
NDC 09900000030
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Aetna American Axle |
$0.49
|
| Rate for Payer: Aetna Commercial |
$0.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.49
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Cofinity Advantage |
$0.53
|
| Rate for Payer: Cofinity Commercial |
$0.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.60
|
| Rate for Payer: Healthscope Commercial |
$0.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.56
|
| Rate for Payer: PHP Commercial |
$0.64
|
| Rate for Payer: Priority Health SBD |
$0.47
|
| Rate for Payer: UMR Bronson Commercial |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.56
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$22.84
|
|
|
Service Code
|
NDC 60687076086
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$20.56 |
| Rate for Payer: Aetna American Axle |
$14.85
|
| Rate for Payer: Aetna Commercial |
$19.41
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.85
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: Cash Price |
$18.27
|
| Rate for Payer: Cofinity Advantage |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$19.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.27
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.13
|
| Rate for Payer: PHP Commercial |
$19.41
|
| Rate for Payer: Priority Health SBD |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC Core |
$11.90
|
| Rate for Payer: UHC Exchange |
$8.98
|
| Rate for Payer: UMR Bronson Commercial |
$8.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.13
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$22.84
|
|
|
Service Code
|
NDC 60687076040
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$20.56 |
| Rate for Payer: Aetna American Axle |
$14.85
|
| Rate for Payer: Aetna Commercial |
$19.41
|
| Rate for Payer: Aetna Medicare |
$11.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.85
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: Cash Price |
$18.27
|
| Rate for Payer: Cofinity Advantage |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$19.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.27
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.13
|
| Rate for Payer: PHP Commercial |
$19.41
|
| Rate for Payer: Priority Health SBD |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.85
|
| Rate for Payer: UHC Core |
$11.90
|
| Rate for Payer: UHC Exchange |
$8.98
|
| Rate for Payer: UMR Bronson Commercial |
$8.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.13
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$22.84
|
|
|
Service Code
|
NDC 60687076086
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$20.56 |
| Rate for Payer: Aetna American Axle |
$14.85
|
| Rate for Payer: Aetna Commercial |
$19.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.85
|
| Rate for Payer: Cash Price |
$18.27
|
| Rate for Payer: Cofinity Advantage |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$19.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.27
|
| Rate for Payer: Healthscope Commercial |
$20.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.13
|
| Rate for Payer: PHP Commercial |
$19.41
|
| Rate for Payer: Priority Health SBD |
$14.39
|
| Rate for Payer: UMR Bronson Commercial |
$10.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.13
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$20.74
|
|
|
Service Code
|
NDC 00121090494
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$18.67 |
| Rate for Payer: Aetna American Axle |
$13.48
|
| Rate for Payer: Aetna Commercial |
$17.63
|
| Rate for Payer: Aetna Medicare |
$10.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.48
|
| Rate for Payer: BCBS Complete |
$8.30
|
| Rate for Payer: Cash Price |
$16.59
|
| Rate for Payer: Cofinity Advantage |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$17.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$18.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: PHP Commercial |
$17.63
|
| Rate for Payer: Priority Health SBD |
$13.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.48
|
| Rate for Payer: UHC Core |
$10.81
|
| Rate for Payer: UHC Exchange |
$8.15
|
| Rate for Payer: UMR Bronson Commercial |
$7.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$0.75
|
|
|
Service Code
|
NDC 09900000030
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.68 |
| Rate for Payer: Aetna American Axle |
$0.49
|
| Rate for Payer: Aetna Commercial |
$0.64
|
| Rate for Payer: Aetna Medicare |
$0.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.49
|
| Rate for Payer: BCBS Complete |
$0.30
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Cofinity Advantage |
$0.53
|
| Rate for Payer: Cofinity Commercial |
$0.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.60
|
| Rate for Payer: Healthscope Commercial |
$0.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.56
|
| Rate for Payer: PHP Commercial |
$0.64
|
| Rate for Payer: Priority Health SBD |
$0.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.49
|
| Rate for Payer: UHC Core |
$0.39
|
| Rate for Payer: UHC Exchange |
$0.29
|
| Rate for Payer: UMR Bronson Commercial |
$0.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.56
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$20.74
|
|
|
Service Code
|
NDC 00121090405
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$9.13 |
| Max. Negotiated Rate |
$18.67 |
| Rate for Payer: Aetna American Axle |
$13.48
|
| Rate for Payer: Aetna Commercial |
$17.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.48
|
| Rate for Payer: Cash Price |
$16.59
|
| Rate for Payer: Cofinity Advantage |
$14.52
|
| Rate for Payer: Cofinity Commercial |
$17.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$18.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.55
|
| Rate for Payer: PHP Commercial |
$17.63
|
| Rate for Payer: Priority Health SBD |
$13.07
|
| Rate for Payer: UMR Bronson Commercial |
$9.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.55
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$7.44
|
|
|
Service Code
|
NDC 00990000103
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna American Axle |
$4.84
|
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.84
|
| Rate for Payer: Cash Price |
$5.95
|
| Rate for Payer: Cofinity Advantage |
$5.21
|
| Rate for Payer: Cofinity Commercial |
$6.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.95
|
| Rate for Payer: Healthscope Commercial |
$6.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.58
|
| Rate for Payer: PHP Commercial |
$6.32
|
| Rate for Payer: Priority Health SBD |
$4.69
|
| Rate for Payer: UMR Bronson Commercial |
$3.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.58
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$1.49
|
|
|
Service Code
|
NDC 0990000102
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna American Axle |
$0.97
|
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.97
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cofinity Advantage |
$1.04
|
| Rate for Payer: Cofinity Commercial |
$1.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.19
|
| Rate for Payer: Healthscope Commercial |
$1.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.12
|
| Rate for Payer: PHP Commercial |
$1.27
|
| Rate for Payer: Priority Health SBD |
$0.94
|
| Rate for Payer: UMR Bronson Commercial |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
