|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$561.75
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$247.17 |
| Max. Negotiated Rate |
$505.57 |
| Rate for Payer: Aetna American Axle |
$365.14
|
| Rate for Payer: Aetna Commercial |
$477.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.14
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cofinity Advantage |
$393.23
|
| Rate for Payer: Cofinity Commercial |
$483.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.40
|
| Rate for Payer: Healthscope Commercial |
$505.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$393.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$421.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.31
|
| Rate for Payer: PHP Commercial |
$477.49
|
| Rate for Payer: Priority Health SBD |
$353.90
|
| Rate for Payer: UMR Bronson Commercial |
$247.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$421.31
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$436.10
|
|
|
Service Code
|
NDC 00406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$191.88 |
| Max. Negotiated Rate |
$392.49 |
| Rate for Payer: Aetna American Axle |
$283.46
|
| Rate for Payer: Aetna Commercial |
$370.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.46
|
| Rate for Payer: Cash Price |
$348.88
|
| Rate for Payer: Cofinity Advantage |
$305.27
|
| Rate for Payer: Cofinity Commercial |
$375.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.88
|
| Rate for Payer: Healthscope Commercial |
$392.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.07
|
| Rate for Payer: PHP Commercial |
$370.69
|
| Rate for Payer: Priority Health SBD |
$274.74
|
| Rate for Payer: UMR Bronson Commercial |
$191.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.07
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$532.00
|
|
|
Service Code
|
NDC 00904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$234.08 |
| Max. Negotiated Rate |
$478.80 |
| Rate for Payer: Aetna American Axle |
$345.80
|
| Rate for Payer: Aetna Commercial |
$452.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.80
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Advantage |
$372.40
|
| Rate for Payer: Cofinity Commercial |
$457.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.60
|
| Rate for Payer: Healthscope Commercial |
$478.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$372.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$399.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.00
|
| Rate for Payer: PHP Commercial |
$452.20
|
| Rate for Payer: Priority Health SBD |
$335.16
|
| Rate for Payer: UMR Bronson Commercial |
$234.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$399.00
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$586.60
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$258.10 |
| Max. Negotiated Rate |
$527.94 |
| Rate for Payer: Aetna American Axle |
$381.29
|
| Rate for Payer: Aetna Commercial |
$498.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.29
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Advantage |
$410.62
|
| Rate for Payer: Cofinity Commercial |
$504.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Healthscope Commercial |
$527.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$410.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: PHP Commercial |
$498.61
|
| Rate for Payer: Priority Health SBD |
$369.56
|
| Rate for Payer: UMR Bronson Commercial |
$258.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.95
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$586.60
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$217.04 |
| Max. Negotiated Rate |
$527.94 |
| Rate for Payer: Aetna American Axle |
$381.29
|
| Rate for Payer: Aetna Commercial |
$498.61
|
| Rate for Payer: Aetna Medicare |
$293.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$381.29
|
| Rate for Payer: BCBS Complete |
$234.64
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Advantage |
$410.62
|
| Rate for Payer: Cofinity Commercial |
$504.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Healthscope Commercial |
$527.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$410.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$469.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: PHP Commercial |
$498.61
|
| Rate for Payer: Priority Health SBD |
$369.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.29
|
| Rate for Payer: UHC Core |
$305.62
|
| Rate for Payer: UHC Exchange |
$230.53
|
| Rate for Payer: UMR Bronson Commercial |
$217.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.95
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$436.10
|
|
|
Service Code
|
NDC 00406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.36 |
| Max. Negotiated Rate |
$392.49 |
| Rate for Payer: Aetna American Axle |
$283.46
|
| Rate for Payer: Aetna Commercial |
$370.69
|
| Rate for Payer: Aetna Medicare |
$218.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.46
|
| Rate for Payer: BCBS Complete |
$174.44
|
| Rate for Payer: Cash Price |
$348.88
|
| Rate for Payer: Cofinity Advantage |
$305.27
|
| Rate for Payer: Cofinity Commercial |
$375.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.88
|
| Rate for Payer: Healthscope Commercial |
$392.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$305.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$327.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.07
|
| Rate for Payer: PHP Commercial |
$370.69
|
| Rate for Payer: Priority Health SBD |
$274.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.46
|
| Rate for Payer: UHC Core |
$227.21
|
| Rate for Payer: UHC Exchange |
$171.39
|
| Rate for Payer: UMR Bronson Commercial |
$161.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$327.07
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$490.00
|
|
|
Service Code
|
NDC 63304045001
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$181.30 |
| Max. Negotiated Rate |
$441.00 |
| Rate for Payer: Aetna American Axle |
$318.50
|
| Rate for Payer: Aetna Commercial |
$416.50
|
| Rate for Payer: Aetna Medicare |
$245.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.50
|
| Rate for Payer: BCBS Complete |
$196.00
|
| Rate for Payer: Cash Price |
$392.00
|
| Rate for Payer: Cofinity Advantage |
$343.00
|
| Rate for Payer: Cofinity Commercial |
$421.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.00
|
| Rate for Payer: Healthscope Commercial |
$441.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$392.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.50
|
| Rate for Payer: PHP Commercial |
$416.50
|
| Rate for Payer: Priority Health SBD |
$308.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$318.50
|
| Rate for Payer: UHC Core |
$255.29
|
| Rate for Payer: UHC Exchange |
$192.57
|
| Rate for Payer: UMR Bronson Commercial |
$181.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.50
|
|
|
MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE 24 HR MULTIPHASE
|
Facility
|
IP
|
$1,892.28
|
|
|
Service Code
|
NDC 00228309011
|
| Hospital Charge Code |
32709
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$832.60 |
| Max. Negotiated Rate |
$1,703.05 |
| Rate for Payer: Aetna American Axle |
$1,229.98
|
| Rate for Payer: Aetna Commercial |
$1,608.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,229.98
|
| Rate for Payer: Cash Price |
$1,513.82
|
| Rate for Payer: Cofinity Advantage |
$1,324.60
|
| Rate for Payer: Cofinity Commercial |
$1,627.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.82
|
| Rate for Payer: Healthscope Commercial |
$1,703.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,324.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.21
|
| Rate for Payer: PHP Commercial |
$1,608.44
|
| Rate for Payer: Priority Health SBD |
$1,192.14
|
| Rate for Payer: UMR Bronson Commercial |
$832.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.21
|
|
|
MORPHINE ER 30 MG CAPSULE,EXTENDED RELEASE 24 HR MULTIPHASE
|
Facility
|
OP
|
$1,892.28
|
|
|
Service Code
|
NDC 00228309011
|
| Hospital Charge Code |
32709
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$700.14 |
| Max. Negotiated Rate |
$1,703.05 |
| Rate for Payer: Aetna American Axle |
$1,229.98
|
| Rate for Payer: Aetna Commercial |
$1,608.44
|
| Rate for Payer: Aetna Medicare |
$946.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,229.98
|
| Rate for Payer: BCBS Complete |
$756.91
|
| Rate for Payer: Cash Price |
$1,513.82
|
| Rate for Payer: Cofinity Advantage |
$1,324.60
|
| Rate for Payer: Cofinity Commercial |
$1,627.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,513.82
|
| Rate for Payer: Healthscope Commercial |
$1,703.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,324.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,419.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,513.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,608.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,419.21
|
| Rate for Payer: PHP Commercial |
$1,608.44
|
| Rate for Payer: Priority Health SBD |
$1,192.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,229.98
|
| Rate for Payer: UHC Core |
$985.88
|
| Rate for Payer: UHC Exchange |
$743.67
|
| Rate for Payer: UMR Bronson Commercial |
$700.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,419.21
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$8.98
|
|
|
Service Code
|
NDC 68084015811
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna American Axle |
$5.84
|
| Rate for Payer: Aetna Commercial |
$7.63
|
| Rate for Payer: Aetna Medicare |
$4.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.84
|
| Rate for Payer: BCBS Complete |
$3.59
|
| Rate for Payer: Cash Price |
$7.18
|
| Rate for Payer: Cofinity Advantage |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$7.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.18
|
| Rate for Payer: Healthscope Commercial |
$8.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.74
|
| Rate for Payer: PHP Commercial |
$7.63
|
| Rate for Payer: Priority Health SBD |
$5.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.84
|
| Rate for Payer: UHC Core |
$4.68
|
| Rate for Payer: UHC Exchange |
$3.53
|
| Rate for Payer: UMR Bronson Commercial |
$3.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.74
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$789.25
|
|
|
Service Code
|
NDC 42858080201
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$292.02 |
| Max. Negotiated Rate |
$710.33 |
| Rate for Payer: Aetna American Axle |
$513.01
|
| Rate for Payer: Aetna Commercial |
$670.86
|
| Rate for Payer: Aetna Medicare |
$394.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.01
|
| Rate for Payer: BCBS Complete |
$315.70
|
| Rate for Payer: Cash Price |
$631.40
|
| Rate for Payer: Cofinity Advantage |
$552.48
|
| Rate for Payer: Cofinity Commercial |
$678.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.40
|
| Rate for Payer: Healthscope Commercial |
$710.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$631.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.94
|
| Rate for Payer: PHP Commercial |
$670.86
|
| Rate for Payer: Priority Health SBD |
$497.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.01
|
| Rate for Payer: UHC Core |
$411.20
|
| Rate for Payer: UHC Exchange |
$310.18
|
| Rate for Payer: UMR Bronson Commercial |
$292.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$8.96
|
|
|
Service Code
|
NDC 00406833023
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.94 |
| Max. Negotiated Rate |
$8.06 |
| Rate for Payer: Aetna American Axle |
$5.82
|
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.82
|
| Rate for Payer: Cash Price |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$6.27
|
| Rate for Payer: Cofinity Commercial |
$7.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.17
|
| Rate for Payer: Healthscope Commercial |
$8.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.72
|
| Rate for Payer: PHP Commercial |
$7.62
|
| Rate for Payer: Priority Health SBD |
$5.64
|
| Rate for Payer: UMR Bronson Commercial |
$3.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.72
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$8.96
|
|
|
Service Code
|
NDC 00406833023
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$8.06 |
| Rate for Payer: Aetna American Axle |
$5.82
|
| Rate for Payer: Aetna Commercial |
$7.62
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.82
|
| Rate for Payer: BCBS Complete |
$3.58
|
| Rate for Payer: Cash Price |
$7.17
|
| Rate for Payer: Cofinity Advantage |
$6.27
|
| Rate for Payer: Cofinity Commercial |
$7.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.17
|
| Rate for Payer: Healthscope Commercial |
$8.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.72
|
| Rate for Payer: PHP Commercial |
$7.62
|
| Rate for Payer: Priority Health SBD |
$5.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.82
|
| Rate for Payer: UHC Core |
$4.67
|
| Rate for Payer: UHC Exchange |
$3.52
|
| Rate for Payer: UMR Bronson Commercial |
$3.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.72
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$897.40
|
|
|
Service Code
|
NDC 68084015801
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$332.04 |
| Max. Negotiated Rate |
$807.66 |
| Rate for Payer: Aetna American Axle |
$583.31
|
| Rate for Payer: Aetna Commercial |
$762.79
|
| Rate for Payer: Aetna Medicare |
$448.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.31
|
| Rate for Payer: BCBS Complete |
$358.96
|
| Rate for Payer: Cash Price |
$717.92
|
| Rate for Payer: Cofinity Advantage |
$628.18
|
| Rate for Payer: Cofinity Commercial |
$771.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$717.92
|
| Rate for Payer: Healthscope Commercial |
$807.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$717.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$762.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.05
|
| Rate for Payer: PHP Commercial |
$762.79
|
| Rate for Payer: Priority Health SBD |
$565.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$583.31
|
| Rate for Payer: UHC Core |
$467.55
|
| Rate for Payer: UHC Exchange |
$352.68
|
| Rate for Payer: UMR Bronson Commercial |
$332.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$829.50
|
|
|
Service Code
|
NDC 00406833001
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$306.92 |
| Max. Negotiated Rate |
$746.55 |
| Rate for Payer: Aetna American Axle |
$539.17
|
| Rate for Payer: Aetna Commercial |
$705.08
|
| Rate for Payer: Aetna Medicare |
$414.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.17
|
| Rate for Payer: BCBS Complete |
$331.80
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Cofinity Advantage |
$580.65
|
| Rate for Payer: Cofinity Commercial |
$713.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.60
|
| Rate for Payer: Healthscope Commercial |
$746.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$663.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.12
|
| Rate for Payer: PHP Commercial |
$705.08
|
| Rate for Payer: Priority Health SBD |
$522.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.17
|
| Rate for Payer: UHC Core |
$432.17
|
| Rate for Payer: UHC Exchange |
$325.99
|
| Rate for Payer: UMR Bronson Commercial |
$306.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.12
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$829.50
|
|
|
Service Code
|
NDC 00406833001
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$364.98 |
| Max. Negotiated Rate |
$746.55 |
| Rate for Payer: Aetna American Axle |
$539.17
|
| Rate for Payer: Aetna Commercial |
$705.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$539.17
|
| Rate for Payer: Cash Price |
$663.60
|
| Rate for Payer: Cofinity Advantage |
$580.65
|
| Rate for Payer: Cofinity Commercial |
$713.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$663.60
|
| Rate for Payer: Healthscope Commercial |
$746.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$580.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$622.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$705.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$622.12
|
| Rate for Payer: PHP Commercial |
$705.08
|
| Rate for Payer: Priority Health SBD |
$522.59
|
| Rate for Payer: UMR Bronson Commercial |
$364.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$622.12
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$789.25
|
|
|
Service Code
|
NDC 42858080201
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.27 |
| Max. Negotiated Rate |
$710.33 |
| Rate for Payer: Aetna American Axle |
$513.01
|
| Rate for Payer: Aetna Commercial |
$670.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$513.01
|
| Rate for Payer: Cash Price |
$631.40
|
| Rate for Payer: Cofinity Advantage |
$552.48
|
| Rate for Payer: Cofinity Commercial |
$678.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.40
|
| Rate for Payer: Healthscope Commercial |
$710.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$591.94
|
| Rate for Payer: PHP Commercial |
$670.86
|
| Rate for Payer: Priority Health SBD |
$497.23
|
| Rate for Payer: UMR Bronson Commercial |
$347.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$895.30
|
|
|
Service Code
|
NDC 00406833062
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$393.93 |
| Max. Negotiated Rate |
$805.77 |
| Rate for Payer: Aetna American Axle |
$581.95
|
| Rate for Payer: Aetna Commercial |
$761.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.95
|
| Rate for Payer: Cash Price |
$716.24
|
| Rate for Payer: Cofinity Advantage |
$626.71
|
| Rate for Payer: Cofinity Commercial |
$769.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.24
|
| Rate for Payer: Healthscope Commercial |
$805.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.48
|
| Rate for Payer: PHP Commercial |
$761.00
|
| Rate for Payer: Priority Health SBD |
$564.04
|
| Rate for Payer: UMR Bronson Commercial |
$393.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.48
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$897.40
|
|
|
Service Code
|
NDC 68084015801
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$394.86 |
| Max. Negotiated Rate |
$807.66 |
| Rate for Payer: Aetna American Axle |
$583.31
|
| Rate for Payer: Aetna Commercial |
$762.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.31
|
| Rate for Payer: Cash Price |
$717.92
|
| Rate for Payer: Cofinity Advantage |
$628.18
|
| Rate for Payer: Cofinity Commercial |
$771.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$717.92
|
| Rate for Payer: Healthscope Commercial |
$807.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$762.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$673.05
|
| Rate for Payer: PHP Commercial |
$762.79
|
| Rate for Payer: Priority Health SBD |
$565.36
|
| Rate for Payer: UMR Bronson Commercial |
$394.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.05
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$8.98
|
|
|
Service Code
|
NDC 68084015811
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.95 |
| Max. Negotiated Rate |
$8.08 |
| Rate for Payer: Aetna American Axle |
$5.84
|
| Rate for Payer: Aetna Commercial |
$7.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.84
|
| Rate for Payer: Cash Price |
$7.18
|
| Rate for Payer: Cofinity Advantage |
$6.29
|
| Rate for Payer: Cofinity Commercial |
$7.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.18
|
| Rate for Payer: Healthscope Commercial |
$8.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.74
|
| Rate for Payer: PHP Commercial |
$7.63
|
| Rate for Payer: Priority Health SBD |
$5.66
|
| Rate for Payer: UMR Bronson Commercial |
$3.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.74
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$895.30
|
|
|
Service Code
|
NDC 00406833062
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$331.26 |
| Max. Negotiated Rate |
$805.77 |
| Rate for Payer: Aetna American Axle |
$581.95
|
| Rate for Payer: Aetna Commercial |
$761.00
|
| Rate for Payer: Aetna Medicare |
$447.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$581.95
|
| Rate for Payer: BCBS Complete |
$358.12
|
| Rate for Payer: Cash Price |
$716.24
|
| Rate for Payer: Cofinity Advantage |
$626.71
|
| Rate for Payer: Cofinity Commercial |
$769.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$716.24
|
| Rate for Payer: Healthscope Commercial |
$805.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$626.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$671.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$716.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$761.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$671.48
|
| Rate for Payer: PHP Commercial |
$761.00
|
| Rate for Payer: Priority Health SBD |
$564.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.95
|
| Rate for Payer: UHC Core |
$466.45
|
| Rate for Payer: UHC Exchange |
$351.85
|
| Rate for Payer: UMR Bronson Commercial |
$331.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$671.48
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$1,127.88
|
|
|
Service Code
|
NDC 00406838062
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$496.27 |
| Max. Negotiated Rate |
$1,015.09 |
| Rate for Payer: Aetna American Axle |
$733.12
|
| Rate for Payer: Aetna Commercial |
$958.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.12
|
| Rate for Payer: Cash Price |
$902.30
|
| Rate for Payer: Cofinity Advantage |
$789.52
|
| Rate for Payer: Cofinity Commercial |
$969.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$902.30
|
| Rate for Payer: Healthscope Commercial |
$1,015.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$789.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$845.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$958.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$845.91
|
| Rate for Payer: PHP Commercial |
$958.70
|
| Rate for Payer: Priority Health SBD |
$710.56
|
| Rate for Payer: UMR Bronson Commercial |
$496.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$845.91
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$1,127.88
|
|
|
Service Code
|
NDC 00406838062
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$417.32 |
| Max. Negotiated Rate |
$1,015.09 |
| Rate for Payer: Aetna American Axle |
$733.12
|
| Rate for Payer: Aetna Commercial |
$958.70
|
| Rate for Payer: Aetna Medicare |
$563.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$733.12
|
| Rate for Payer: BCBS Complete |
$451.15
|
| Rate for Payer: Cash Price |
$902.30
|
| Rate for Payer: Cofinity Advantage |
$789.52
|
| Rate for Payer: Cofinity Commercial |
$969.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$902.30
|
| Rate for Payer: Healthscope Commercial |
$1,015.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$789.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$845.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$902.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$958.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$845.91
|
| Rate for Payer: PHP Commercial |
$958.70
|
| Rate for Payer: Priority Health SBD |
$710.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$733.12
|
| Rate for Payer: UHC Core |
$587.63
|
| Rate for Payer: UHC Exchange |
$443.26
|
| Rate for Payer: UMR Bronson Commercial |
$417.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$845.91
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$1,025.31
|
|
|
Service Code
|
NDC 00904655961
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$451.14 |
| Max. Negotiated Rate |
$922.78 |
| Rate for Payer: Aetna American Axle |
$666.45
|
| Rate for Payer: Aetna Commercial |
$871.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.45
|
| Rate for Payer: Cash Price |
$820.25
|
| Rate for Payer: Cofinity Advantage |
$717.72
|
| Rate for Payer: Cofinity Commercial |
$881.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.25
|
| Rate for Payer: Healthscope Commercial |
$922.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$717.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$871.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.98
|
| Rate for Payer: PHP Commercial |
$871.51
|
| Rate for Payer: Priority Health SBD |
$645.95
|
| Rate for Payer: UMR Bronson Commercial |
$451.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.98
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$1,025.31
|
|
|
Service Code
|
NDC 00904655961
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$379.36 |
| Max. Negotiated Rate |
$922.78 |
| Rate for Payer: Aetna American Axle |
$666.45
|
| Rate for Payer: Aetna Commercial |
$871.51
|
| Rate for Payer: Aetna Medicare |
$512.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$666.45
|
| Rate for Payer: BCBS Complete |
$410.12
|
| Rate for Payer: Cash Price |
$820.25
|
| Rate for Payer: Cofinity Advantage |
$717.72
|
| Rate for Payer: Cofinity Commercial |
$881.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$820.25
|
| Rate for Payer: Healthscope Commercial |
$922.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$717.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$820.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$871.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$768.98
|
| Rate for Payer: PHP Commercial |
$871.51
|
| Rate for Payer: Priority Health SBD |
$645.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.45
|
| Rate for Payer: UHC Core |
$534.19
|
| Rate for Payer: UHC Exchange |
$402.95
|
| Rate for Payer: UMR Bronson Commercial |
$379.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.98
|
|
