|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$35.44
|
|
|
Service Code
|
NDC 00121495594
|
| 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
|
$376.25
|
|
|
Service Code
|
NDC 00054023763
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$139.21 |
| Max. Negotiated Rate |
$338.62 |
| Rate for Payer: Aetna American Axle |
$244.56
|
| Rate for Payer: Aetna Commercial |
$319.81
|
| Rate for Payer: Aetna Medicare |
$188.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.56
|
| Rate for Payer: BCBS Complete |
$150.50
|
| 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: MI Amish Medical Board Commercial |
$301.00
|
| 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: UHC All Payor (Choice/PPO) |
$244.56
|
| Rate for Payer: UHC Core |
$196.03
|
| Rate for Payer: UHC Exchange |
$147.87
|
| Rate for Payer: UMR Bronson Commercial |
$139.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$282.19
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
OP
|
$7.44
|
|
|
Service Code
|
NDC 00990000103
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$6.70 |
| Rate for Payer: Aetna American Axle |
$4.84
|
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.84
|
| Rate for Payer: BCBS Complete |
$2.98
|
| 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: MI Amish Medical Board Commercial |
$5.95
|
| 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: UHC All Payor (Choice/PPO) |
$4.84
|
| Rate for Payer: UHC Core |
$3.88
|
| Rate for Payer: UHC Exchange |
$2.92
|
| Rate for Payer: UMR Bronson Commercial |
$2.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.58
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$20.74
|
|
|
Service Code
|
NDC 00121090494
|
| 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
|
OP
|
$1.49
|
|
|
Service Code
|
NDC 0990000102
|
| Hospital Charge Code |
5176
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.55 |
| Max. Negotiated Rate |
$1.34 |
| Rate for Payer: Aetna American Axle |
$0.97
|
| Rate for Payer: Aetna Commercial |
$1.27
|
| Rate for Payer: Aetna Medicare |
$0.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.97
|
| Rate for Payer: BCBS Complete |
$0.60
|
| 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: MI Amish Medical Board Commercial |
$1.19
|
| 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: UHC All Payor (Choice/PPO) |
$0.97
|
| Rate for Payer: UHC Core |
$0.78
|
| Rate for Payer: UHC Exchange |
$0.59
|
| Rate for Payer: UMR Bronson Commercial |
$0.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.12
|
|
|
MORPHINE 10 MG/5 ML ORAL SOLUTION
|
Facility
|
IP
|
$22.84
|
|
|
Service Code
|
NDC 60687076040
|
| 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/ML INJECTION SOLUTION
|
Facility
|
OP
|
$33.73
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5168
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$30.36 |
| Rate for Payer: Aetna American Axle |
$21.92
|
| Rate for Payer: Aetna Commercial |
$28.67
|
| Rate for Payer: Aetna Medicare |
$16.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.92
|
| Rate for Payer: BCBS Complete |
$13.49
|
| Rate for Payer: BCBS Trust/PPO |
$21.93
|
| Rate for Payer: BCN Commercial |
$21.93
|
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Cofinity Advantage |
$23.61
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.98
|
| Rate for Payer: Healthscope Commercial |
$30.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.30
|
| Rate for Payer: PHP Commercial |
$28.67
|
| Rate for Payer: Priority Health SBD |
$21.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.17
|
| Rate for Payer: UHC Core |
$11.17
|
| Rate for Payer: UHC Exchange |
$11.17
|
| Rate for Payer: UMR Bronson Commercial |
$12.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.30
|
|
|
MORPHINE 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$33.73
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5168
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.84 |
| Max. Negotiated Rate |
$30.36 |
| Rate for Payer: Aetna American Axle |
$21.92
|
| Rate for Payer: Aetna Commercial |
$28.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.92
|
| Rate for Payer: Cash Price |
$26.98
|
| Rate for Payer: Cofinity Advantage |
$23.61
|
| Rate for Payer: Cofinity Commercial |
$29.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.98
|
| Rate for Payer: Healthscope Commercial |
$30.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.30
|
| Rate for Payer: PHP Commercial |
$28.67
|
| Rate for Payer: Priority Health SBD |
$21.25
|
| Rate for Payer: UMR Bronson Commercial |
$14.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.30
|
|
|
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 |
$5.02 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna American Axle |
$11.36
|
| Rate for Payer: Aetna Commercial |
$14.85
|
| Rate for Payer: Aetna Medicare |
$8.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS Trust/PPO |
$9.83
|
| Rate for Payer: BCN Commercial |
$9.83
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Advantage |
$12.23
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$12.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.85
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.02
|
| Rate for Payer: UHC Core |
$5.02
|
| Rate for Payer: UHC Exchange |
$5.02
|
| Rate for Payer: UMR Bronson Commercial |
$6.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.10
|
|
|
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 |
$7.69 |
| Max. Negotiated Rate |
$15.72 |
| Rate for Payer: Aetna American Axle |
$11.36
|
| Rate for Payer: Aetna Commercial |
$14.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.36
|
| Rate for Payer: Cash Price |
$13.98
|
| Rate for Payer: Cofinity Advantage |
$12.23
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$12.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.10
|
| Rate for Payer: PHP Commercial |
$14.85
|
| Rate for Payer: Priority Health SBD |
$11.01
|
| Rate for Payer: UMR Bronson Commercial |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.10
|
|
|
MORPHINE 10 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
OP
|
$32.49
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
172788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$29.24 |
| Rate for Payer: Aetna American Axle |
$21.12
|
| Rate for Payer: Aetna Commercial |
$27.62
|
| Rate for Payer: Aetna Medicare |
$16.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.12
|
| Rate for Payer: BCBS Complete |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$9.83
|
| Rate for Payer: BCN Commercial |
$9.83
|
| Rate for Payer: Cash Price |
$25.99
|
| Rate for Payer: Cash Price |
$25.99
|
| Rate for Payer: Cofinity Advantage |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$27.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.99
|
| Rate for Payer: Healthscope Commercial |
$29.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.37
|
| Rate for Payer: PHP Commercial |
$27.62
|
| Rate for Payer: Priority Health SBD |
$20.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.02
|
| Rate for Payer: UHC Core |
$5.02
|
| Rate for Payer: UHC Exchange |
$5.02
|
| Rate for Payer: UMR Bronson Commercial |
$12.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.37
|
|
|
MORPHINE 10 MG/ML INTRAVENOUS SYRINGE
|
Facility
|
IP
|
$32.49
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
172788
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.30 |
| Max. Negotiated Rate |
$29.24 |
| Rate for Payer: Aetna American Axle |
$21.12
|
| Rate for Payer: Aetna Commercial |
$27.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.12
|
| Rate for Payer: Cash Price |
$25.99
|
| Rate for Payer: Cofinity Advantage |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$27.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.99
|
| Rate for Payer: Healthscope Commercial |
$29.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.37
|
| Rate for Payer: PHP Commercial |
$27.62
|
| Rate for Payer: Priority Health SBD |
$20.47
|
| Rate for Payer: UMR Bronson Commercial |
$14.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.37
|
|
|
MORPHINE 10 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$16.52
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
163726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.27 |
| Max. Negotiated Rate |
$14.87 |
| Rate for Payer: Aetna American Axle |
$10.74
|
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.74
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cofinity Advantage |
$11.56
|
| Rate for Payer: Cofinity Commercial |
$14.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Healthscope Commercial |
$14.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.39
|
| Rate for Payer: PHP Commercial |
$14.04
|
| Rate for Payer: Priority Health SBD |
$10.41
|
| Rate for Payer: UMR Bronson Commercial |
$7.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.39
|
|
|
MORPHINE 10 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$16.52
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
163726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$14.87 |
| Rate for Payer: Aetna American Axle |
$10.74
|
| Rate for Payer: Aetna Commercial |
$14.04
|
| Rate for Payer: Aetna Medicare |
$8.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.74
|
| Rate for Payer: BCBS Complete |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$9.83
|
| Rate for Payer: BCN Commercial |
$9.83
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cofinity Advantage |
$11.56
|
| Rate for Payer: Cofinity Commercial |
$14.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Healthscope Commercial |
$14.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.39
|
| Rate for Payer: PHP Commercial |
$14.04
|
| Rate for Payer: Priority Health SBD |
$10.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.02
|
| Rate for Payer: UHC Core |
$5.02
|
| Rate for Payer: UHC Exchange |
$5.02
|
| Rate for Payer: UMR Bronson Commercial |
$6.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.39
|
|
|
MORPHINE 10 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$265.88
|
|
|
Service Code
|
NDC 00574711212
|
| Hospital Charge Code |
5180
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$98.38 |
| Max. Negotiated Rate |
$239.29 |
| Rate for Payer: Aetna American Axle |
$172.82
|
| Rate for Payer: Aetna Commercial |
$226.00
|
| Rate for Payer: Aetna Medicare |
$132.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.82
|
| Rate for Payer: BCBS Complete |
$106.35
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cofinity Advantage |
$186.12
|
| Rate for Payer: Cofinity Commercial |
$228.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.70
|
| Rate for Payer: Healthscope Commercial |
$239.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.41
|
| Rate for Payer: PHP Commercial |
$226.00
|
| Rate for Payer: Priority Health SBD |
$167.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.82
|
| Rate for Payer: UHC Core |
$138.52
|
| Rate for Payer: UHC Exchange |
$104.49
|
| Rate for Payer: UMR Bronson Commercial |
$98.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.41
|
|
|
MORPHINE 10 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$265.88
|
|
|
Service Code
|
NDC 00574711212
|
| Hospital Charge Code |
5180
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$116.99 |
| Max. Negotiated Rate |
$239.29 |
| Rate for Payer: Aetna American Axle |
$172.82
|
| Rate for Payer: Aetna Commercial |
$226.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.82
|
| Rate for Payer: Cash Price |
$212.70
|
| Rate for Payer: Cofinity Advantage |
$186.12
|
| Rate for Payer: Cofinity Commercial |
$228.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.70
|
| Rate for Payer: Healthscope Commercial |
$239.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$186.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$199.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.41
|
| Rate for Payer: PHP Commercial |
$226.00
|
| Rate for Payer: Priority Health SBD |
$167.50
|
| Rate for Payer: UMR Bronson Commercial |
$116.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$199.41
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$527.10
|
|
|
Service Code
|
NDC 00406511862
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$195.03 |
| Max. Negotiated Rate |
$474.39 |
| Rate for Payer: Aetna American Axle |
$342.62
|
| Rate for Payer: Aetna Commercial |
$448.04
|
| Rate for Payer: Aetna Medicare |
$263.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.62
|
| Rate for Payer: BCBS Complete |
$210.84
|
| Rate for Payer: Cash Price |
$421.68
|
| Rate for Payer: Cofinity Advantage |
$368.97
|
| Rate for Payer: Cofinity Commercial |
$453.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$421.68
|
| Rate for Payer: Healthscope Commercial |
$474.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$368.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$395.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$448.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$395.32
|
| Rate for Payer: PHP Commercial |
$448.04
|
| Rate for Payer: Priority Health SBD |
$332.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$342.62
|
| Rate for Payer: UHC Core |
$274.62
|
| Rate for Payer: UHC Exchange |
$207.15
|
| Rate for Payer: UMR Bronson Commercial |
$195.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$395.32
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$542.50
|
|
|
Service Code
|
NDC 00054023525
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$238.70 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna American Axle |
$352.62
|
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.62
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Advantage |
$379.75
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.88
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: Priority Health SBD |
$341.77
|
| Rate for Payer: UMR Bronson Commercial |
$238.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
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 |
$45.65 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Aetna American Axle |
$80.20
|
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: Aetna Medicare |
$61.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.20
|
| Rate for Payer: BCBS Complete |
$49.35
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Advantage |
$86.37
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$86.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.53
|
| Rate for Payer: PHP Commercial |
$104.87
|
| Rate for Payer: Priority Health SBD |
$77.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.20
|
| Rate for Payer: UHC Core |
$64.28
|
| Rate for Payer: UHC Exchange |
$48.49
|
| Rate for Payer: UMR Bronson Commercial |
$45.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.53
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$703.50
|
|
|
Service Code
|
NDC 51862061501
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$309.54 |
| Max. Negotiated Rate |
$633.15 |
| Rate for Payer: Aetna American Axle |
$457.27
|
| Rate for Payer: Aetna Commercial |
$597.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.27
|
| Rate for Payer: Cash Price |
$562.80
|
| Rate for Payer: Cofinity Advantage |
$492.45
|
| Rate for Payer: Cofinity Commercial |
$605.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$562.80
|
| Rate for Payer: Healthscope Commercial |
$633.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$492.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$527.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$597.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.62
|
| Rate for Payer: PHP Commercial |
$597.98
|
| Rate for Payer: Priority Health SBD |
$443.20
|
| Rate for Payer: UMR Bronson Commercial |
$309.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$527.62
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$542.50
|
|
|
Service Code
|
NDC 00054023525
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$200.72 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna American Axle |
$352.62
|
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: Aetna Medicare |
$271.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.62
|
| Rate for Payer: BCBS Complete |
$217.00
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Advantage |
$379.75
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$434.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$461.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$406.88
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: Priority Health SBD |
$341.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.62
|
| Rate for Payer: UHC Core |
$282.64
|
| Rate for Payer: UHC Exchange |
$213.20
|
| Rate for Payer: UMR Bronson Commercial |
$200.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
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 |
$54.29 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Aetna American Axle |
$80.20
|
| Rate for Payer: Aetna Commercial |
$104.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.20
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Advantage |
$86.37
|
| 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: Kalamazoo County Sherrif's Dept Commercial |
$86.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.53
|
| Rate for Payer: PHP Commercial |
$104.87
|
| Rate for Payer: Priority Health SBD |
$77.73
|
| Rate for Payer: UMR Bronson Commercial |
$54.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.53
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$5.28
|
|
|
Service Code
|
NDC 00406511823
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.32 |
| Max. Negotiated Rate |
$4.75 |
| Rate for Payer: Aetna American Axle |
$3.43
|
| Rate for Payer: Aetna Commercial |
$4.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.43
|
| Rate for Payer: Cash Price |
$4.22
|
| Rate for Payer: Cofinity Advantage |
$3.70
|
| Rate for Payer: Cofinity Commercial |
$4.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.22
|
| Rate for Payer: Healthscope Commercial |
$4.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.96
|
| Rate for Payer: PHP Commercial |
$4.49
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UMR Bronson Commercial |
$2.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.96
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$703.50
|
|
|
Service Code
|
NDC 51862061501
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$260.30 |
| Max. Negotiated Rate |
$633.15 |
| Rate for Payer: Aetna American Axle |
$457.27
|
| Rate for Payer: Aetna Commercial |
$597.98
|
| Rate for Payer: Aetna Medicare |
$351.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$457.27
|
| Rate for Payer: BCBS Complete |
$281.40
|
| Rate for Payer: Cash Price |
$562.80
|
| Rate for Payer: Cofinity Advantage |
$492.45
|
| Rate for Payer: Cofinity Commercial |
$605.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$562.80
|
| Rate for Payer: Healthscope Commercial |
$633.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$492.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$527.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$597.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$527.62
|
| Rate for Payer: PHP Commercial |
$597.98
|
| Rate for Payer: Priority Health SBD |
$443.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.27
|
| Rate for Payer: UHC Core |
$366.52
|
| Rate for Payer: UHC Exchange |
$276.48
|
| Rate for Payer: UMR Bronson Commercial |
$260.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$527.62
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$5.28
|
|
|
Service Code
|
NDC 00406511823
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$4.75 |
| Rate for Payer: Aetna American Axle |
$3.43
|
| Rate for Payer: Aetna Commercial |
$4.49
|
| Rate for Payer: Aetna Medicare |
$2.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.43
|
| Rate for Payer: BCBS Complete |
$2.11
|
| Rate for Payer: Cash Price |
$4.22
|
| Rate for Payer: Cofinity Advantage |
$3.70
|
| Rate for Payer: Cofinity Commercial |
$4.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.22
|
| Rate for Payer: Healthscope Commercial |
$4.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.96
|
| Rate for Payer: PHP Commercial |
$4.49
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.43
|
| Rate for Payer: UHC Core |
$2.75
|
| Rate for Payer: UHC Exchange |
$2.08
|
| Rate for Payer: UMR Bronson Commercial |
$1.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.96
|
|
