|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$7.89
|
|
|
Service Code
|
NDC 00406833023
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$7.10 |
| Rate for Payer: Aetna American Axle |
$5.13
|
| Rate for Payer: Aetna Commercial |
$6.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.13
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$5.52
|
| Rate for Payer: Cofinity Commercial |
$6.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$5.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$7.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: PHP Commercial |
$6.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health SBD |
$4.97
|
| Rate for Payer: UMR Bronson Commercial |
$3.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5.92
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$787.50
|
|
|
Service Code
|
NDC 42858080201
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.38 |
| Max. Negotiated Rate |
$708.75 |
| Rate for Payer: Aetna American Axle |
$511.88
|
| Rate for Payer: Aetna Commercial |
$669.38
|
| Rate for Payer: Aetna Medicare |
$393.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.88
|
| Rate for Payer: BCBS Complete |
$315.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cofinity Commercial |
$551.25
|
| Rate for Payer: Cofinity Commercial |
$677.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$551.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.00
|
| Rate for Payer: Healthscope Commercial |
$708.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$669.38
|
| Rate for Payer: PHP Commercial |
$669.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$511.88
|
| Rate for Payer: Priority Health SBD |
$496.12
|
| Rate for Payer: UMR Bronson Commercial |
$291.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.62
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$788.90
|
|
|
Service Code
|
NDC 00406833062
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$291.89 |
| Max. Negotiated Rate |
$710.01 |
| Rate for Payer: Aetna American Axle |
$512.78
|
| Rate for Payer: Aetna Commercial |
$670.56
|
| Rate for Payer: Aetna Medicare |
$394.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.78
|
| Rate for Payer: BCBS Complete |
$315.56
|
| Rate for Payer: Cash Price |
$631.12
|
| Rate for Payer: Cofinity Commercial |
$552.23
|
| Rate for Payer: Cofinity Commercial |
$678.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.12
|
| Rate for Payer: Healthscope Commercial |
$710.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.56
|
| Rate for Payer: PHP Commercial |
$670.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.78
|
| Rate for Payer: Priority Health SBD |
$497.01
|
| Rate for Payer: UMR Bronson Commercial |
$291.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.68
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$820.40
|
|
|
Service Code
|
NDC 00406833001
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$360.98 |
| Max. Negotiated Rate |
$738.36 |
| Rate for Payer: Aetna American Axle |
$533.26
|
| Rate for Payer: Aetna Commercial |
$697.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.26
|
| Rate for Payer: Cash Price |
$656.32
|
| Rate for Payer: Cofinity Commercial |
$574.28
|
| Rate for Payer: Cofinity Commercial |
$705.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.32
|
| Rate for Payer: Healthscope Commercial |
$738.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$697.34
|
| Rate for Payer: PHP Commercial |
$697.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.26
|
| Rate for Payer: Priority Health SBD |
$516.85
|
| Rate for Payer: UMR Bronson Commercial |
$360.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.30
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$788.90
|
|
|
Service Code
|
NDC 00406833062
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$347.12 |
| Max. Negotiated Rate |
$710.01 |
| Rate for Payer: Aetna American Axle |
$512.78
|
| Rate for Payer: Aetna Commercial |
$670.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.78
|
| Rate for Payer: Cash Price |
$631.12
|
| Rate for Payer: Cofinity Commercial |
$552.23
|
| Rate for Payer: Cofinity Commercial |
$678.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$552.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.12
|
| Rate for Payer: Healthscope Commercial |
$710.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$552.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$591.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.56
|
| Rate for Payer: PHP Commercial |
$670.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.78
|
| Rate for Payer: Priority Health SBD |
$497.01
|
| Rate for Payer: UMR Bronson Commercial |
$347.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$591.68
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$820.40
|
|
|
Service Code
|
NDC 00406833001
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$303.55 |
| Max. Negotiated Rate |
$738.36 |
| Rate for Payer: Aetna American Axle |
$533.26
|
| Rate for Payer: Aetna Commercial |
$697.34
|
| Rate for Payer: Aetna Medicare |
$410.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.26
|
| Rate for Payer: BCBS Complete |
$328.16
|
| Rate for Payer: Cash Price |
$656.32
|
| Rate for Payer: Cofinity Commercial |
$574.28
|
| Rate for Payer: Cofinity Commercial |
$705.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$574.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.32
|
| Rate for Payer: Healthscope Commercial |
$738.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$697.34
|
| Rate for Payer: PHP Commercial |
$697.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.26
|
| Rate for Payer: Priority Health SBD |
$516.85
|
| Rate for Payer: UMR Bronson Commercial |
$303.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.30
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$898.95
|
|
|
Service Code
|
NDC 00904655961
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$332.61 |
| Max. Negotiated Rate |
$809.06 |
| Rate for Payer: Aetna American Axle |
$584.32
|
| Rate for Payer: Aetna Commercial |
$764.11
|
| Rate for Payer: Aetna Medicare |
$449.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.32
|
| Rate for Payer: BCBS Complete |
$359.58
|
| Rate for Payer: Cash Price |
$719.16
|
| Rate for Payer: Cofinity Commercial |
$629.26
|
| Rate for Payer: Cofinity Commercial |
$773.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$629.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.16
|
| Rate for Payer: Healthscope Commercial |
$809.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$629.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$674.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.11
|
| Rate for Payer: PHP Commercial |
$764.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.32
|
| Rate for Payer: Priority Health SBD |
$566.34
|
| Rate for Payer: UMR Bronson Commercial |
$332.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$674.21
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$1,049.88
|
|
|
Service Code
|
NDC 00406838062
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$388.46 |
| Max. Negotiated Rate |
$944.89 |
| Rate for Payer: Aetna American Axle |
$682.42
|
| Rate for Payer: Aetna Commercial |
$892.40
|
| Rate for Payer: Aetna Medicare |
$524.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.42
|
| Rate for Payer: BCBS Complete |
$419.95
|
| Rate for Payer: Cash Price |
$839.90
|
| Rate for Payer: Cofinity Commercial |
$734.92
|
| Rate for Payer: Cofinity Commercial |
$902.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$734.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$839.90
|
| Rate for Payer: Healthscope Commercial |
$944.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$734.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$787.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$892.40
|
| Rate for Payer: PHP Commercial |
$892.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.42
|
| Rate for Payer: Priority Health SBD |
$661.42
|
| Rate for Payer: UMR Bronson Commercial |
$388.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$787.41
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$898.95
|
|
|
Service Code
|
NDC 00904655961
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$395.54 |
| Max. Negotiated Rate |
$809.06 |
| Rate for Payer: Aetna American Axle |
$584.32
|
| Rate for Payer: Aetna Commercial |
$764.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$584.32
|
| Rate for Payer: Cash Price |
$719.16
|
| Rate for Payer: Cofinity Commercial |
$629.26
|
| Rate for Payer: Cofinity Commercial |
$773.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$629.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$719.16
|
| Rate for Payer: Healthscope Commercial |
$809.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$629.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$674.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$764.11
|
| Rate for Payer: PHP Commercial |
$764.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$584.32
|
| Rate for Payer: Priority Health SBD |
$566.34
|
| Rate for Payer: UMR Bronson Commercial |
$395.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$674.21
|
|
|
MORPHINE ER 60 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$1,049.88
|
|
|
Service Code
|
NDC 00406838062
|
| Hospital Charge Code |
20922
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$461.95 |
| Max. Negotiated Rate |
$944.89 |
| Rate for Payer: Cofinity Commercial |
$902.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$734.92
|
| Rate for Payer: Cofinity Commercial |
$734.92
|
| Rate for Payer: Aetna American Axle |
$682.42
|
| Rate for Payer: Aetna Commercial |
$892.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$682.42
|
| Rate for Payer: Cash Price |
$839.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$839.90
|
| Rate for Payer: Healthscope Commercial |
$944.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$734.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$787.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$892.40
|
| Rate for Payer: PHP Commercial |
$892.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$682.42
|
| Rate for Payer: Priority Health SBD |
$661.42
|
| Rate for Payer: UMR Bronson Commercial |
$461.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$787.41
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
OP
|
$11.62
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$13.05 |
| Rate for Payer: PHP Commercial |
$9.88
|
| Rate for Payer: Aetna American Axle |
$7.55
|
| Rate for Payer: Aetna Commercial |
$9.88
|
| Rate for Payer: Aetna Medicare |
$5.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.55
|
| Rate for Payer: BCBS Complete |
$4.65
|
| Rate for Payer: BCBS Trust/PPO |
$13.05
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cofinity Commercial |
$8.13
|
| Rate for Payer: Cofinity Commercial |
$9.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$10.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.55
|
| Rate for Payer: Priority Health SBD |
$7.32
|
| Rate for Payer: UMR Bronson Commercial |
$4.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
IP
|
$11.62
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$10.46 |
| Rate for Payer: Aetna American Axle |
$7.55
|
| Rate for Payer: Aetna Commercial |
$9.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.55
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cofinity Commercial |
$8.13
|
| Rate for Payer: Cofinity Commercial |
$9.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$10.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: PHP Commercial |
$9.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.55
|
| Rate for Payer: Priority Health SBD |
$7.32
|
| Rate for Payer: UMR Bronson Commercial |
$5.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.72
|
|
|
MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$134.55
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
29464
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$121.10 |
| Rate for Payer: Aetna American Axle |
$87.46
|
| Rate for Payer: Aetna American Axle |
$25.97
|
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna Commercial |
$114.37
|
| Rate for Payer: Aetna Medicare |
$67.28
|
| Rate for Payer: Aetna Medicare |
$19.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.97
|
| Rate for Payer: BCBS Complete |
$15.98
|
| Rate for Payer: BCBS Complete |
$53.82
|
| Rate for Payer: BCBS Trust/PPO |
$28.21
|
| Rate for Payer: BCBS Trust/PPO |
$28.21
|
| Rate for Payer: BCN Commercial |
$28.21
|
| Rate for Payer: BCN Commercial |
$28.21
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cash Price |
$107.64
|
| Rate for Payer: Cash Price |
$107.64
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Cofinity Commercial |
$115.71
|
| Rate for Payer: Cofinity Commercial |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$94.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.64
|
| Rate for Payer: Healthscope Commercial |
$35.96
|
| Rate for Payer: Healthscope Commercial |
$121.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: PHP Commercial |
$114.37
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health SBD |
$25.17
|
| Rate for Payer: Priority Health SBD |
$84.77
|
| Rate for Payer: UMR Bronson Commercial |
$49.78
|
| Rate for Payer: UMR Bronson Commercial |
$14.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.91
|
|
|
MORPHINE (PF) 0.5 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$134.55
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
29464
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$121.10 |
| Rate for Payer: Aetna American Axle |
$87.46
|
| Rate for Payer: Aetna American Axle |
$25.97
|
| Rate for Payer: Aetna Commercial |
$114.37
|
| Rate for Payer: Aetna Commercial |
$33.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.97
|
| Rate for Payer: Cash Price |
$107.64
|
| Rate for Payer: Cash Price |
$31.96
|
| Rate for Payer: Cofinity Commercial |
$34.36
|
| Rate for Payer: Cofinity Commercial |
$27.96
|
| Rate for Payer: Cofinity Commercial |
$115.71
|
| Rate for Payer: Cofinity Commercial |
$94.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.96
|
| Rate for Payer: Healthscope Commercial |
$121.10
|
| Rate for Payer: Healthscope Commercial |
$35.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.37
|
| Rate for Payer: PHP Commercial |
$33.96
|
| Rate for Payer: PHP Commercial |
$114.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.97
|
| Rate for Payer: Priority Health SBD |
$84.77
|
| Rate for Payer: Priority Health SBD |
$25.17
|
| Rate for Payer: UMR Bronson Commercial |
$59.20
|
| Rate for Payer: UMR Bronson Commercial |
$17.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.96
|
|
|
MORPHINE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$670.25
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
77009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.21 |
| Max. Negotiated Rate |
$603.22 |
| Rate for Payer: Aetna American Axle |
$435.66
|
| Rate for Payer: Aetna Commercial |
$569.71
|
| Rate for Payer: Aetna Medicare |
$335.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.66
|
| Rate for Payer: BCBS Complete |
$268.10
|
| Rate for Payer: BCBS Trust/PPO |
$28.21
|
| Rate for Payer: BCN Commercial |
$28.21
|
| Rate for Payer: Cash Price |
$536.20
|
| Rate for Payer: Cash Price |
$536.20
|
| Rate for Payer: Cofinity Commercial |
$469.18
|
| Rate for Payer: Cofinity Commercial |
$576.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$469.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.20
|
| Rate for Payer: Healthscope Commercial |
$603.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$569.71
|
| Rate for Payer: PHP Commercial |
$569.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.66
|
| Rate for Payer: Priority Health SBD |
$422.26
|
| Rate for Payer: UMR Bronson Commercial |
$247.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.69
|
|
|
MORPHINE (PF) 10 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$670.25
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
77009
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$294.91 |
| Max. Negotiated Rate |
$603.22 |
| Rate for Payer: Aetna American Axle |
$435.66
|
| Rate for Payer: Aetna Commercial |
$569.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.66
|
| Rate for Payer: Cash Price |
$536.20
|
| Rate for Payer: Cofinity Commercial |
$469.18
|
| Rate for Payer: Cofinity Commercial |
$576.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$469.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$536.20
|
| Rate for Payer: Healthscope Commercial |
$603.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$469.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$502.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$569.71
|
| Rate for Payer: PHP Commercial |
$569.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$435.66
|
| Rate for Payer: Priority Health SBD |
$422.26
|
| Rate for Payer: UMR Bronson Commercial |
$294.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$502.69
|
|
|
MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$66.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
159447
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$59.85 |
| Rate for Payer: Aetna American Axle |
$43.22
|
| Rate for Payer: Aetna Commercial |
$56.52
|
| Rate for Payer: Aetna Medicare |
$33.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.22
|
| Rate for Payer: BCBS Complete |
$26.60
|
| Rate for Payer: BCBS Trust/PPO |
$13.05
|
| Rate for Payer: BCN Commercial |
$13.05
|
| Rate for Payer: Cash Price |
$53.20
|
| Rate for Payer: Cash Price |
$53.20
|
| Rate for Payer: Cofinity Commercial |
$46.55
|
| Rate for Payer: Cofinity Commercial |
$57.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.20
|
| Rate for Payer: Healthscope Commercial |
$59.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.52
|
| Rate for Payer: PHP Commercial |
$56.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.22
|
| Rate for Payer: Priority Health SBD |
$41.90
|
| Rate for Payer: UMR Bronson Commercial |
$24.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.88
|
|
|
MORPHINE (PF) 1 MG/ML IN 0.9% SODIUM CHLORIDE INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$66.50
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
159447
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$29.26 |
| Max. Negotiated Rate |
$59.85 |
| Rate for Payer: Aetna American Axle |
$43.22
|
| Rate for Payer: Aetna Commercial |
$56.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.22
|
| Rate for Payer: Cash Price |
$53.20
|
| Rate for Payer: Cofinity Commercial |
$46.55
|
| Rate for Payer: Cofinity Commercial |
$57.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.20
|
| Rate for Payer: Healthscope Commercial |
$59.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.52
|
| Rate for Payer: PHP Commercial |
$56.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.22
|
| Rate for Payer: Priority Health SBD |
$41.90
|
| Rate for Payer: UMR Bronson Commercial |
$29.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.88
|
|
|
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$41.80
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
15852
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$37.62 |
| Rate for Payer: Aetna American Axle |
$27.17
|
| Rate for Payer: Aetna Commercial |
$35.53
|
| Rate for Payer: Aetna Medicare |
$20.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.17
|
| Rate for Payer: BCBS Complete |
$16.72
|
| Rate for Payer: BCBS Trust/PPO |
$28.21
|
| Rate for Payer: BCN Commercial |
$28.21
|
| Rate for Payer: Cash Price |
$33.44
|
| Rate for Payer: Cash Price |
$33.44
|
| Rate for Payer: Cofinity Commercial |
$29.26
|
| Rate for Payer: Cofinity Commercial |
$35.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.44
|
| Rate for Payer: Healthscope Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.53
|
| Rate for Payer: PHP Commercial |
$35.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.17
|
| Rate for Payer: Priority Health SBD |
$26.33
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.35
|
|
|
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$41.80
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
15852
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.39 |
| Max. Negotiated Rate |
$37.62 |
| Rate for Payer: Aetna American Axle |
$27.17
|
| Rate for Payer: Aetna Commercial |
$35.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.17
|
| Rate for Payer: Cash Price |
$33.44
|
| Rate for Payer: Cofinity Commercial |
$29.26
|
| Rate for Payer: Cofinity Commercial |
$35.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.44
|
| Rate for Payer: Healthscope Commercial |
$37.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.53
|
| Rate for Payer: PHP Commercial |
$35.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.17
|
| Rate for Payer: Priority Health SBD |
$26.33
|
| Rate for Payer: UMR Bronson Commercial |
$18.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.35
|
|
|
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$1,041.92
|
|
|
Service Code
|
NDC 00641604001
|
| Hospital Charge Code |
27392
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$385.51 |
| Max. Negotiated Rate |
$937.73 |
| Rate for Payer: Aetna American Axle |
$677.25
|
| Rate for Payer: Aetna Commercial |
$885.63
|
| Rate for Payer: Aetna Medicare |
$520.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.25
|
| Rate for Payer: BCBS Complete |
$416.77
|
| Rate for Payer: Cash Price |
$833.54
|
| Rate for Payer: Cofinity Commercial |
$729.34
|
| Rate for Payer: Cofinity Commercial |
$896.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$729.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.54
|
| Rate for Payer: Healthscope Commercial |
$937.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.63
|
| Rate for Payer: PHP Commercial |
$885.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.25
|
| Rate for Payer: Priority Health SBD |
$656.41
|
| Rate for Payer: UMR Bronson Commercial |
$385.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.44
|
|
|
MORPHINE (PF) 25 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$1,041.92
|
|
|
Service Code
|
NDC 00641604001
|
| Hospital Charge Code |
27392
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$458.44 |
| Max. Negotiated Rate |
$937.73 |
| Rate for Payer: Aetna American Axle |
$677.25
|
| Rate for Payer: Aetna Commercial |
$885.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$677.25
|
| Rate for Payer: Cash Price |
$833.54
|
| Rate for Payer: Cofinity Commercial |
$729.34
|
| Rate for Payer: Cofinity Commercial |
$896.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$729.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$833.54
|
| Rate for Payer: Healthscope Commercial |
$937.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$729.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$781.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$885.63
|
| Rate for Payer: PHP Commercial |
$885.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$677.25
|
| Rate for Payer: Priority Health SBD |
$656.41
|
| Rate for Payer: UMR Bronson Commercial |
$458.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$781.44
|
|
|
MORPHINE (PF) 2 MG/2 ML (1 MG/ML) IN 0.9% SODIUM CHLORIDE INJ SYRINGE
|
Facility
|
IP
|
$31.50
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
159461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Aetna American Axle |
$20.48
|
| Rate for Payer: Aetna Commercial |
$26.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.48
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$28.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.78
|
| Rate for Payer: PHP Commercial |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.48
|
| Rate for Payer: Priority Health SBD |
$19.84
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
MORPHINE (PF) 2 MG/2 ML (1 MG/ML) IN 0.9% SODIUM CHLORIDE INJ SYRINGE
|
Facility
|
OP
|
$31.50
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
159461
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$28.35 |
| Rate for Payer: Aetna American Axle |
$20.48
|
| Rate for Payer: Aetna Commercial |
$26.78
|
| Rate for Payer: Aetna Medicare |
$15.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.48
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$28.21
|
| Rate for Payer: BCN Commercial |
$28.21
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: Cofinity Commercial |
$22.05
|
| Rate for Payer: Cofinity Commercial |
$27.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$28.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.78
|
| Rate for Payer: PHP Commercial |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.48
|
| Rate for Payer: Priority Health SBD |
$19.84
|
| Rate for Payer: UMR Bronson Commercial |
$11.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
MORPHINE SULFATE 100 MG/0.5 ML TOPICAL GEL
|
Facility
|
IP
|
$17.49
|
|
|
Service Code
|
NDC 09900000372
|
| Hospital Charge Code |
161534
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$15.74 |
| Rate for Payer: Aetna American Axle |
$11.37
|
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.37
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: Cofinity Commercial |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$15.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.99
|
| Rate for Payer: Healthscope Commercial |
$15.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.87
|
| Rate for Payer: PHP Commercial |
$14.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.37
|
| Rate for Payer: Priority Health SBD |
$11.02
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.12
|
|
