|
MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE PEDIATRIC INFUSION
|
Facility
|
OP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
180632
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.77
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$16.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: BCBS Complete |
$13.40
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.77
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: UMR Bronson Commercial |
$12.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML IN 0.9 % SODIUM CHLORIDE PEDIATRIC INFUSION
|
Facility
|
IP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
180632
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.77
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.77
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: UMR Bronson Commercial |
$14.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML IV INFUSION (IV PREMIX) 100 ML
|
Facility
|
OP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
151077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.39 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.77
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$16.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: BCBS Complete |
$13.40
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.77
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: UMR Bronson Commercial |
$12.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML IV INFUSION (IV PREMIX) 100 ML
|
Facility
|
IP
|
$33.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
151077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.77
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.77
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.77
|
| Rate for Payer: Priority Health SBD |
$21.11
|
| Rate for Payer: UMR Bronson Commercial |
$14.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
MORPHINE 1 MG/ML PEDIATRIC PCA IV SOLUTION
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300298
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.64 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$56.70
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.70
|
| 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: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| 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 1 MG/ML PEDIATRIC PCA IV SOLUTION
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300298
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.97 |
| 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: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$56.70
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.70
|
| 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: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UMR Bronson Commercial |
$29.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
MORPHINE 20 MG RECTAL SUPPOSITORY
|
Facility
|
IP
|
$273.08
|
|
|
Service Code
|
NDC 00574711412
|
| Hospital Charge Code |
5181
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$120.16 |
| Max. Negotiated Rate |
$245.77 |
| Rate for Payer: Aetna American Axle |
$177.50
|
| Rate for Payer: Aetna Commercial |
$232.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.50
|
| Rate for Payer: Cash Price |
$218.46
|
| Rate for Payer: Cofinity Commercial |
$191.16
|
| Rate for Payer: Cofinity Commercial |
$234.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.46
|
| Rate for Payer: Healthscope Commercial |
$245.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.12
|
| Rate for Payer: PHP Commercial |
$232.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.50
|
| Rate for Payer: Priority Health SBD |
$172.04
|
| Rate for Payer: UMR Bronson Commercial |
$120.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.81
|
|
|
MORPHINE 20 MG RECTAL SUPPOSITORY
|
Facility
|
OP
|
$273.08
|
|
|
Service Code
|
NDC 00574711412
|
| Hospital Charge Code |
5181
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$101.04 |
| Max. Negotiated Rate |
$245.77 |
| Rate for Payer: Aetna American Axle |
$177.50
|
| Rate for Payer: Aetna Commercial |
$232.12
|
| Rate for Payer: Aetna Medicare |
$136.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.50
|
| Rate for Payer: BCBS Complete |
$109.23
|
| Rate for Payer: Cash Price |
$218.46
|
| Rate for Payer: Cofinity Commercial |
$191.16
|
| Rate for Payer: Cofinity Commercial |
$234.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$191.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.46
|
| Rate for Payer: Healthscope Commercial |
$245.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.12
|
| Rate for Payer: PHP Commercial |
$232.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.50
|
| Rate for Payer: Priority Health SBD |
$172.04
|
| Rate for Payer: UMR Bronson Commercial |
$101.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.81
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$15.31
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.74 |
| Max. Negotiated Rate |
$13.78 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: Cash Price |
$12.25
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Cofinity Commercial |
$13.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health SBD |
$9.65
|
| Rate for Payer: UMR Bronson Commercial |
$6.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$26.76
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.90 |
| Max. Negotiated Rate |
$24.08 |
| Rate for Payer: Aetna American Axle |
$17.39
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.39
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$18.73
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health SBD |
$16.86
|
| Rate for Payer: UMR Bronson Commercial |
$9.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$15.31
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$13.78 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna American Axle |
$19.35
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna Commercial |
$25.30
|
| Rate for Payer: Aetna Medicare |
$7.66
|
| Rate for Payer: Aetna Medicare |
$14.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.35
|
| Rate for Payer: BCBS Complete |
$6.12
|
| Rate for Payer: BCBS Complete |
$11.91
|
| Rate for Payer: Cash Price |
$12.25
|
| Rate for Payer: Cash Price |
$23.82
|
| Rate for Payer: Cofinity Commercial |
$13.17
|
| Rate for Payer: Cofinity Commercial |
$10.72
|
| Rate for Payer: Cofinity Commercial |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$20.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.25
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$26.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PHP Commercial |
$25.30
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.35
|
| Rate for Payer: Priority Health SBD |
$18.76
|
| Rate for Payer: Priority Health SBD |
$9.65
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: UMR Bronson Commercial |
$11.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.33
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$26.76
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$24.08 |
| Rate for Payer: Aetna American Axle |
$17.39
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.39
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$18.73
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health SBD |
$16.86
|
| Rate for Payer: UMR Bronson Commercial |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
|
|
MORPHINE 4 MG/4 ML INJECTION SOLUTION
|
Facility
|
OP
|
$29.79
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$26.81 |
| Rate for Payer: Aetna American Axle |
$19.36
|
| Rate for Payer: Aetna Commercial |
$25.32
|
| Rate for Payer: Aetna Medicare |
$14.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.36
|
| Rate for Payer: BCBS Complete |
$11.92
|
| Rate for Payer: Cash Price |
$23.83
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Cofinity Commercial |
$25.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$26.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.32
|
| Rate for Payer: PHP Commercial |
$25.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.36
|
| Rate for Payer: Priority Health SBD |
$18.77
|
| Rate for Payer: UMR Bronson Commercial |
$11.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.34
|
|
|
MORPHINE 4 MG/4 ML INJECTION SOLUTION
|
Facility
|
IP
|
$29.79
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
300093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.11 |
| Max. Negotiated Rate |
$26.81 |
| Rate for Payer: Aetna American Axle |
$19.36
|
| Rate for Payer: Aetna Commercial |
$25.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.36
|
| Rate for Payer: Cash Price |
$23.83
|
| Rate for Payer: Cofinity Commercial |
$20.85
|
| Rate for Payer: Cofinity Commercial |
$25.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.83
|
| Rate for Payer: Healthscope Commercial |
$26.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.32
|
| Rate for Payer: PHP Commercial |
$25.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.36
|
| Rate for Payer: Priority Health SBD |
$18.77
|
| Rate for Payer: UMR Bronson Commercial |
$13.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.34
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$25.81
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.55 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna American Axle |
$16.78
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna Medicare |
$12.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.78
|
| Rate for Payer: BCBS Complete |
$10.32
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cofinity Commercial |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.78
|
| Rate for Payer: Priority Health SBD |
$16.26
|
| Rate for Payer: UMR Bronson Commercial |
$9.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$25.81
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$23.23 |
| Rate for Payer: Aetna American Axle |
$16.78
|
| Rate for Payer: Aetna Commercial |
$21.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.78
|
| Rate for Payer: Cash Price |
$20.65
|
| Rate for Payer: Cofinity Commercial |
$18.07
|
| Rate for Payer: Cofinity Commercial |
$22.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.65
|
| Rate for Payer: Healthscope Commercial |
$23.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.94
|
| Rate for Payer: PHP Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.78
|
| Rate for Payer: Priority Health SBD |
$16.26
|
| Rate for Payer: UMR Bronson Commercial |
$11.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.36
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$22.85
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$20.57 |
| Rate for Payer: Aetna American Axle |
$14.85
|
| Rate for Payer: Aetna American Axle |
$23.57
|
| Rate for Payer: Aetna American Axle |
$10.53
|
| Rate for Payer: Aetna American Axle |
$17.39
|
| Rate for Payer: Aetna Commercial |
$30.82
|
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna Medicare |
$8.10
|
| Rate for Payer: Aetna Medicare |
$18.13
|
| Rate for Payer: Aetna Medicare |
$11.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.53
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS Complete |
$14.50
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS Complete |
$9.14
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$29.01
|
| Rate for Payer: Cofinity Commercial |
$19.65
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Cofinity Commercial |
$11.34
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Commercial |
$18.73
|
| Rate for Payer: Cofinity Commercial |
$25.38
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$14.58
|
| Rate for Payer: Healthscope Commercial |
$20.57
|
| Rate for Payer: Healthscope Commercial |
$32.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$19.42
|
| Rate for Payer: PHP Commercial |
$30.82
|
| Rate for Payer: PHP Commercial |
$13.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.53
|
| Rate for Payer: Priority Health SBD |
$16.86
|
| Rate for Payer: Priority Health SBD |
$22.84
|
| Rate for Payer: Priority Health SBD |
$14.40
|
| Rate for Payer: Priority Health SBD |
$10.21
|
| Rate for Payer: UMR Bronson Commercial |
$9.90
|
| Rate for Payer: UMR Bronson Commercial |
$8.45
|
| Rate for Payer: UMR Bronson Commercial |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$5.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.14
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$26.76
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$24.08 |
| Rate for Payer: Aetna American Axle |
$17.39
|
| Rate for Payer: Aetna American Axle |
$14.85
|
| Rate for Payer: Aetna American Axle |
$10.53
|
| Rate for Payer: Aetna American Axle |
$23.57
|
| Rate for Payer: Aetna Commercial |
$22.75
|
| Rate for Payer: Aetna Commercial |
$30.82
|
| Rate for Payer: Aetna Commercial |
$19.42
|
| Rate for Payer: Aetna Commercial |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.39
|
| Rate for Payer: Cash Price |
$18.28
|
| Rate for Payer: Cash Price |
$21.41
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$29.01
|
| Rate for Payer: Cofinity Commercial |
$11.34
|
| Rate for Payer: Cofinity Commercial |
$31.18
|
| Rate for Payer: Cofinity Commercial |
$25.38
|
| Rate for Payer: Cofinity Commercial |
$18.73
|
| Rate for Payer: Cofinity Commercial |
$15.99
|
| Rate for Payer: Cofinity Commercial |
$19.65
|
| Rate for Payer: Cofinity Commercial |
$23.01
|
| Rate for Payer: Cofinity Commercial |
$13.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$11.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.28
|
| Rate for Payer: Healthscope Commercial |
$24.08
|
| Rate for Payer: Healthscope Commercial |
$14.58
|
| Rate for Payer: Healthscope Commercial |
$20.57
|
| Rate for Payer: Healthscope Commercial |
$32.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$22.75
|
| Rate for Payer: PHP Commercial |
$30.82
|
| Rate for Payer: PHP Commercial |
$13.77
|
| Rate for Payer: PHP Commercial |
$19.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.53
|
| Rate for Payer: Priority Health SBD |
$22.84
|
| Rate for Payer: Priority Health SBD |
$10.21
|
| Rate for Payer: Priority Health SBD |
$14.40
|
| Rate for Payer: Priority Health SBD |
$16.86
|
| Rate for Payer: UMR Bronson Commercial |
$11.77
|
| Rate for Payer: UMR Bronson Commercial |
$15.95
|
| Rate for Payer: UMR Bronson Commercial |
$10.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.07
|
|
|
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$123.05
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
109061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$54.14 |
| Max. Negotiated Rate |
$110.75 |
| Rate for Payer: Aetna American Axle |
$79.98
|
| Rate for Payer: Aetna American Axle |
$37.66
|
| Rate for Payer: Aetna American Axle |
$45.59
|
| Rate for Payer: Aetna Commercial |
$49.25
|
| Rate for Payer: Aetna Commercial |
$104.59
|
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: Cash Price |
$56.11
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Cofinity Commercial |
$86.14
|
| Rate for Payer: Cofinity Commercial |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$40.56
|
| Rate for Payer: Cofinity Commercial |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$105.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
| Rate for Payer: Healthscope Commercial |
$52.15
|
| Rate for Payer: Healthscope Commercial |
$110.75
|
| Rate for Payer: Healthscope Commercial |
$63.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.25
|
| Rate for Payer: PHP Commercial |
$59.62
|
| Rate for Payer: PHP Commercial |
$49.25
|
| Rate for Payer: PHP Commercial |
$104.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.98
|
| Rate for Payer: Priority Health SBD |
$44.19
|
| Rate for Payer: Priority Health SBD |
$36.50
|
| Rate for Payer: Priority Health SBD |
$77.52
|
| Rate for Payer: UMR Bronson Commercial |
$54.14
|
| Rate for Payer: UMR Bronson Commercial |
$30.86
|
| Rate for Payer: UMR Bronson Commercial |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.45
|
|
|
MORPHINE 50 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$70.14
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
109061
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.95 |
| Max. Negotiated Rate |
$63.13 |
| Rate for Payer: Aetna American Axle |
$45.59
|
| Rate for Payer: Aetna American Axle |
$79.98
|
| Rate for Payer: Aetna American Axle |
$37.66
|
| Rate for Payer: Aetna Commercial |
$59.62
|
| Rate for Payer: Aetna Commercial |
$49.25
|
| Rate for Payer: Aetna Commercial |
$104.59
|
| Rate for Payer: Aetna Medicare |
$35.07
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Aetna Medicare |
$61.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.98
|
| Rate for Payer: BCBS Complete |
$49.22
|
| Rate for Payer: BCBS Complete |
$23.18
|
| Rate for Payer: BCBS Complete |
$28.06
|
| Rate for Payer: Cash Price |
$56.11
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Cofinity Commercial |
$49.83
|
| Rate for Payer: Cofinity Commercial |
$105.82
|
| Rate for Payer: Cofinity Commercial |
$86.14
|
| Rate for Payer: Cofinity Commercial |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$40.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.11
|
| Rate for Payer: Healthscope Commercial |
$110.75
|
| Rate for Payer: Healthscope Commercial |
$52.15
|
| Rate for Payer: Healthscope Commercial |
$63.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.62
|
| Rate for Payer: PHP Commercial |
$104.59
|
| Rate for Payer: PHP Commercial |
$49.25
|
| Rate for Payer: PHP Commercial |
$59.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.98
|
| Rate for Payer: Priority Health SBD |
$36.50
|
| Rate for Payer: Priority Health SBD |
$77.52
|
| Rate for Payer: Priority Health SBD |
$44.19
|
| Rate for Payer: UMR Bronson Commercial |
$25.95
|
| Rate for Payer: UMR Bronson Commercial |
$45.53
|
| Rate for Payer: UMR Bronson Commercial |
$21.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.60
|
|
|
MORPHINE 7.5 MG IMMEDIATE RELEASE CUSTOM TABLET
|
Facility
|
OP
|
$2.28
|
|
|
Service Code
|
NDC 09900001130
|
| Hospital Charge Code |
300182
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Aetna American Axle |
$1.48
|
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: Aetna Medicare |
$1.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.48
|
| Rate for Payer: BCBS Complete |
$0.91
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$2.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.94
|
| Rate for Payer: PHP Commercial |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.48
|
| Rate for Payer: Priority Health SBD |
$1.44
|
| Rate for Payer: UMR Bronson Commercial |
$0.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.71
|
|
|
MORPHINE 7.5 MG IMMEDIATE RELEASE CUSTOM TABLET
|
Facility
|
IP
|
$2.28
|
|
|
Service Code
|
NDC 09900001130
|
| Hospital Charge Code |
300182
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$2.05 |
| Rate for Payer: Aetna American Axle |
$1.48
|
| Rate for Payer: Aetna Commercial |
$1.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.48
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cofinity Commercial |
$1.60
|
| Rate for Payer: Cofinity Commercial |
$1.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.82
|
| Rate for Payer: Healthscope Commercial |
$2.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.94
|
| Rate for Payer: PHP Commercial |
$1.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.48
|
| Rate for Payer: Priority Health SBD |
$1.44
|
| Rate for Payer: UMR Bronson Commercial |
$1.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.71
|
|
|
MORPHINE (BULK) 100 % POWDER
|
Facility
|
OP
|
$110.39
|
|
|
Service Code
|
NDC 00406152153
|
| Hospital Charge Code |
5184
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$40.84 |
| Max. Negotiated Rate |
$99.35 |
| Rate for Payer: Aetna American Axle |
$71.75
|
| Rate for Payer: Aetna Commercial |
$93.83
|
| Rate for Payer: Aetna Medicare |
$55.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.75
|
| Rate for Payer: BCBS Complete |
$44.16
|
| Rate for Payer: Cash Price |
$88.31
|
| Rate for Payer: Cofinity Commercial |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$94.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.31
|
| Rate for Payer: Healthscope Commercial |
$99.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.83
|
| Rate for Payer: PHP Commercial |
$93.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.75
|
| Rate for Payer: Priority Health SBD |
$69.55
|
| Rate for Payer: UMR Bronson Commercial |
$40.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.79
|
|
|
MORPHINE (BULK) 100 % POWDER
|
Facility
|
IP
|
$110.39
|
|
|
Service Code
|
NDC 00406152153
|
| Hospital Charge Code |
5184
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.57 |
| Max. Negotiated Rate |
$99.35 |
| Rate for Payer: Aetna American Axle |
$71.75
|
| Rate for Payer: Aetna Commercial |
$93.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.75
|
| Rate for Payer: Cash Price |
$88.31
|
| Rate for Payer: Cofinity Commercial |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$94.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.31
|
| Rate for Payer: Healthscope Commercial |
$99.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.83
|
| Rate for Payer: PHP Commercial |
$93.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.75
|
| Rate for Payer: Priority Health SBD |
$69.55
|
| Rate for Payer: UMR Bronson Commercial |
$48.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.79
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.68
|
|
|
Service Code
|
NDC 68094005658
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.32 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Aetna American Axle |
$7.59
|
| Rate for Payer: Aetna Commercial |
$9.93
|
| Rate for Payer: Aetna Medicare |
$5.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.59
|
| Rate for Payer: BCBS Complete |
$4.67
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cofinity Commercial |
$10.04
|
| Rate for Payer: Cofinity Commercial |
$8.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$10.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.93
|
| Rate for Payer: PHP Commercial |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.59
|
| Rate for Payer: Priority Health SBD |
$7.36
|
| Rate for Payer: UMR Bronson Commercial |
$4.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.76
|
|
