|
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$17.46
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
27390
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$17.46 |
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: ASR ASR |
$16.94
|
| Rate for Payer: ASR Commercial |
$16.94
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$13.54
|
| Rate for Payer: Cash Price |
$13.97
|
| Rate for Payer: Cofinity Commercial |
$16.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.97
|
| Rate for Payer: Healthscope Commercial |
$17.46
|
| Rate for Payer: Healthscope Whirlpool |
$16.94
|
| Rate for Payer: Mclaren Commercial |
$15.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.84
|
| Rate for Payer: Nomi Health Commercial |
$14.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.36
|
|
|
MORPHINE 10 MG/ML SYRINGE (CODE)
|
Facility
|
OP
|
$16.52
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
163726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: Aetna Medicare |
$8.26
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: ASR Commercial |
$16.02
|
| Rate for Payer: BCBS Complete |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$13.53
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Healthscope Whirlpool |
$16.02
|
| Rate for Payer: Mclaren Commercial |
$14.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Nomi Health Commercial |
$13.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$3.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
|
|
MORPHINE 10 MG/ML SYRINGE (CODE)
|
Facility
|
IP
|
$16.52
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
163726
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: ASR Commercial |
$16.02
|
| Rate for Payer: BCBS Trust/PPO |
$13.46
|
| Rate for Payer: BCN Commercial |
$12.81
|
| Rate for Payer: Cash Price |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$15.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.22
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Healthscope Whirlpool |
$16.02
|
| Rate for Payer: Mclaren Commercial |
$14.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Nomi Health Commercial |
$13.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$123.38
|
|
|
Service Code
|
NDC 00054023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$80.20 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: ASR ASR |
$119.68
|
| Rate for Payer: ASR Commercial |
$119.68
|
| Rate for Payer: BCBS Trust/PPO |
$100.54
|
| Rate for Payer: BCN Commercial |
$95.66
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Healthscope Whirlpool |
$119.68
|
| Rate for Payer: Mclaren Commercial |
$111.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Nomi Health Commercial |
$101.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$123.38
|
|
|
Service Code
|
NDC 00054023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$49.35 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: Aetna Medicare |
$61.69
|
| Rate for Payer: ASR ASR |
$119.68
|
| Rate for Payer: ASR Commercial |
$119.68
|
| Rate for Payer: BCBS Complete |
$49.35
|
| Rate for Payer: BCBS Trust/PPO |
$101.04
|
| Rate for Payer: BCN Commercial |
$95.66
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Healthscope Whirlpool |
$119.68
|
| Rate for Payer: Mclaren Commercial |
$111.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Nomi Health Commercial |
$101.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.11
|
| Rate for Payer: Priority Health Narrow Network |
$86.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$26.75
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: ASR Commercial |
$25.95
|
| Rate for Payer: BCBS Trust/PPO |
$21.80
|
| Rate for Payer: BCN Commercial |
$20.74
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$25.95
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
|
|
MORPHINE 2 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$26.75
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5170
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: ASR Commercial |
$25.95
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$20.74
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$25.95
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$3.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
|
|
MORPHINE 4 MG/ML INJECTION SOLUTION
|
Facility
|
OP
|
$30.80
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
186563
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: Aetna Medicare |
$15.40
|
| Rate for Payer: ASR ASR |
$29.88
|
| Rate for Payer: ASR Commercial |
$29.88
|
| Rate for Payer: BCBS Complete |
$12.32
|
| Rate for Payer: BCBS Trust/PPO |
$25.22
|
| Rate for Payer: BCN Commercial |
$23.88
|
| Rate for Payer: Cash Price |
$24.64
|
| Rate for Payer: Cash Price |
$24.64
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.64
|
| Rate for Payer: Healthscope Commercial |
$30.80
|
| Rate for Payer: Healthscope Whirlpool |
$29.88
|
| Rate for Payer: Mclaren Commercial |
$27.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.18
|
| Rate for Payer: Nomi Health Commercial |
$25.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$5.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.10
|
|
|
MORPHINE 4 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$30.80
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
186563
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: ASR ASR |
$29.88
|
| Rate for Payer: ASR Commercial |
$29.88
|
| Rate for Payer: BCBS Trust/PPO |
$25.10
|
| Rate for Payer: BCN Commercial |
$23.88
|
| Rate for Payer: Cash Price |
$24.64
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.64
|
| Rate for Payer: Healthscope Commercial |
$30.80
|
| Rate for Payer: Healthscope Whirlpool |
$29.88
|
| Rate for Payer: Mclaren Commercial |
$27.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.18
|
| Rate for Payer: Nomi Health Commercial |
$25.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.10
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$25.97
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.88 |
| Max. Negotiated Rate |
$25.97 |
| Rate for Payer: Aetna Commercial |
$23.37
|
| Rate for Payer: Aetna Commercial |
$14.29
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: ASR ASR |
$15.40
|
| Rate for Payer: ASR Commercial |
$15.40
|
| Rate for Payer: ASR Commercial |
$25.19
|
| Rate for Payer: BCBS Trust/PPO |
$12.94
|
| Rate for Payer: BCBS Trust/PPO |
$21.16
|
| Rate for Payer: BCN Commercial |
$20.13
|
| Rate for Payer: BCN Commercial |
$12.31
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$24.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Healthscope Commercial |
$15.88
|
| Rate for Payer: Healthscope Commercial |
$25.97
|
| Rate for Payer: Healthscope Whirlpool |
$15.40
|
| Rate for Payer: Healthscope Whirlpool |
$25.19
|
| Rate for Payer: Mclaren Commercial |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$23.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.85
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$25.97
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$25.97 |
| Rate for Payer: Aetna Commercial |
$23.37
|
| Rate for Payer: Aetna Commercial |
$14.29
|
| Rate for Payer: Aetna Medicare |
$7.94
|
| Rate for Payer: Aetna Medicare |
$12.98
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: ASR ASR |
$15.40
|
| Rate for Payer: ASR Commercial |
$15.40
|
| Rate for Payer: ASR Commercial |
$25.19
|
| Rate for Payer: BCBS Complete |
$10.39
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCBS Trust/PPO |
$13.00
|
| Rate for Payer: BCN Commercial |
$12.31
|
| Rate for Payer: BCN Commercial |
$20.13
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$24.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.70
|
| Rate for Payer: Healthscope Commercial |
$25.97
|
| Rate for Payer: Healthscope Commercial |
$15.88
|
| Rate for Payer: Healthscope Whirlpool |
$25.19
|
| Rate for Payer: Healthscope Whirlpool |
$15.40
|
| Rate for Payer: Mclaren Commercial |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$23.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.89
|
| Rate for Payer: Priority Health Narrow Network |
$5.51
|
| Rate for Payer: Priority Health Narrow Network |
$5.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.85
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$26.75
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: ASR Commercial |
$25.95
|
| Rate for Payer: BCBS Trust/PPO |
$21.80
|
| Rate for Payer: BCN Commercial |
$20.74
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$25.95
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
OP
|
$26.75
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: ASR Commercial |
$25.95
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$20.74
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$25.95
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$3.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.12
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$11.12 |
| Rate for Payer: Aetna Commercial |
$10.01
|
| Rate for Payer: Aetna Medicare |
$5.56
|
| Rate for Payer: ASR ASR |
$10.79
|
| Rate for Payer: ASR Commercial |
$10.79
|
| Rate for Payer: BCBS Complete |
$4.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.11
|
| Rate for Payer: BCN Commercial |
$8.62
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$11.12
|
| Rate for Payer: Healthscope Whirlpool |
$10.79
|
| Rate for Payer: Mclaren Commercial |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.45
|
| Rate for Payer: Nomi Health Commercial |
$9.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.74
|
| Rate for Payer: Priority Health Narrow Network |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.79
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.12
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$11.12 |
| Rate for Payer: Aetna Commercial |
$10.01
|
| Rate for Payer: ASR ASR |
$10.79
|
| Rate for Payer: ASR Commercial |
$10.79
|
| Rate for Payer: BCBS Trust/PPO |
$9.06
|
| Rate for Payer: BCN Commercial |
$8.62
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$11.12
|
| Rate for Payer: Healthscope Whirlpool |
$10.79
|
| Rate for Payer: Mclaren Commercial |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.45
|
| Rate for Payer: Nomi Health Commercial |
$9.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.79
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.12
|
|
|
Service Code
|
NDC 68094004558
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$7.23 |
| Max. Negotiated Rate |
$11.12 |
| Rate for Payer: Aetna Commercial |
$10.01
|
| Rate for Payer: ASR ASR |
$10.79
|
| Rate for Payer: ASR Commercial |
$10.79
|
| Rate for Payer: BCBS Trust/PPO |
$9.06
|
| Rate for Payer: BCN Commercial |
$8.62
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$11.12
|
| Rate for Payer: Healthscope Whirlpool |
$10.79
|
| Rate for Payer: Mclaren Commercial |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.45
|
| Rate for Payer: Nomi Health Commercial |
$9.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.79
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.12
|
|
|
Service Code
|
NDC 68094004558
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$11.12 |
| Rate for Payer: Aetna Commercial |
$10.01
|
| Rate for Payer: Aetna Medicare |
$5.56
|
| Rate for Payer: ASR ASR |
$10.79
|
| Rate for Payer: ASR Commercial |
$10.79
|
| Rate for Payer: BCBS Complete |
$4.45
|
| Rate for Payer: BCBS Trust/PPO |
$9.11
|
| Rate for Payer: BCN Commercial |
$8.62
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$10.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.90
|
| Rate for Payer: Healthscope Commercial |
$11.12
|
| Rate for Payer: Healthscope Whirlpool |
$10.79
|
| Rate for Payer: Mclaren Commercial |
$10.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.45
|
| Rate for Payer: Nomi Health Commercial |
$9.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.74
|
| Rate for Payer: Priority Health Narrow Network |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$9.79
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$511.00
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$332.15 |
| Max. Negotiated Rate |
$511.00 |
| Rate for Payer: Aetna Commercial |
$459.90
|
| Rate for Payer: ASR ASR |
$495.67
|
| Rate for Payer: ASR Commercial |
$495.67
|
| Rate for Payer: BCBS Trust/PPO |
$416.41
|
| Rate for Payer: BCN Commercial |
$396.18
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$480.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.80
|
| Rate for Payer: Healthscope Commercial |
$511.00
|
| Rate for Payer: Healthscope Whirlpool |
$495.67
|
| Rate for Payer: Mclaren Commercial |
$459.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.35
|
| Rate for Payer: Nomi Health Commercial |
$419.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.68
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$511.00
|
|
|
Service Code
|
NDC 00406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$204.40 |
| Max. Negotiated Rate |
$511.00 |
| Rate for Payer: Aetna Commercial |
$459.90
|
| Rate for Payer: Aetna Medicare |
$255.50
|
| Rate for Payer: ASR ASR |
$495.67
|
| Rate for Payer: ASR Commercial |
$495.67
|
| Rate for Payer: BCBS Complete |
$204.40
|
| Rate for Payer: BCBS Trust/PPO |
$418.46
|
| Rate for Payer: BCN Commercial |
$396.18
|
| Rate for Payer: Cash Price |
$408.80
|
| Rate for Payer: Cofinity Commercial |
$480.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$408.80
|
| Rate for Payer: Healthscope Commercial |
$511.00
|
| Rate for Payer: Healthscope Whirlpool |
$495.67
|
| Rate for Payer: Mclaren Commercial |
$459.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$434.35
|
| Rate for Payer: Nomi Health Commercial |
$419.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$447.74
|
| Rate for Payer: Priority Health Narrow Network |
$358.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$449.68
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.11
|
|
|
Service Code
|
NDC 00406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.04 |
| Max. Negotiated Rate |
$5.11 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: Aetna Medicare |
$2.56
|
| Rate for Payer: ASR ASR |
$4.96
|
| Rate for Payer: ASR Commercial |
$4.96
|
| Rate for Payer: BCBS Complete |
$2.04
|
| Rate for Payer: BCBS Trust/PPO |
$4.18
|
| Rate for Payer: BCN Commercial |
$3.96
|
| Rate for Payer: Cash Price |
$4.09
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.09
|
| Rate for Payer: Healthscope Commercial |
$5.11
|
| Rate for Payer: Healthscope Whirlpool |
$4.96
|
| Rate for Payer: Mclaren Commercial |
$4.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.34
|
| Rate for Payer: Nomi Health Commercial |
$4.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.50
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$560.00
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$224.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$504.00
|
| Rate for Payer: Aetna Medicare |
$280.00
|
| Rate for Payer: ASR ASR |
$543.20
|
| Rate for Payer: ASR Commercial |
$543.20
|
| Rate for Payer: BCBS Complete |
$224.00
|
| Rate for Payer: BCBS Trust/PPO |
$458.58
|
| Rate for Payer: BCN Commercial |
$434.17
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.00
|
| Rate for Payer: Healthscope Commercial |
$560.00
|
| Rate for Payer: Healthscope Whirlpool |
$543.20
|
| Rate for Payer: Mclaren Commercial |
$504.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.00
|
| Rate for Payer: Nomi Health Commercial |
$459.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$490.67
|
| Rate for Payer: Priority Health Narrow Network |
$392.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$492.80
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$560.00
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$364.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Aetna Commercial |
$504.00
|
| Rate for Payer: ASR ASR |
$543.20
|
| Rate for Payer: ASR Commercial |
$543.20
|
| Rate for Payer: BCBS Trust/PPO |
$456.34
|
| Rate for Payer: BCN Commercial |
$434.17
|
| Rate for Payer: Cash Price |
$448.00
|
| Rate for Payer: Cofinity Commercial |
$526.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$448.00
|
| Rate for Payer: Healthscope Commercial |
$560.00
|
| Rate for Payer: Healthscope Whirlpool |
$543.20
|
| Rate for Payer: Mclaren Commercial |
$504.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.00
|
| Rate for Payer: Nomi Health Commercial |
$459.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$492.80
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$922.25
|
|
|
Service Code
|
NDC 00904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$368.90 |
| Max. Negotiated Rate |
$922.25 |
| Rate for Payer: Aetna Commercial |
$830.02
|
| Rate for Payer: Aetna Medicare |
$461.12
|
| Rate for Payer: ASR ASR |
$894.58
|
| Rate for Payer: ASR Commercial |
$894.58
|
| Rate for Payer: BCBS Complete |
$368.90
|
| Rate for Payer: BCBS Trust/PPO |
$755.23
|
| Rate for Payer: BCN Commercial |
$715.02
|
| Rate for Payer: Cash Price |
$737.80
|
| Rate for Payer: Cofinity Commercial |
$866.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.80
|
| Rate for Payer: Healthscope Commercial |
$922.25
|
| Rate for Payer: Healthscope Whirlpool |
$894.58
|
| Rate for Payer: Mclaren Commercial |
$830.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.91
|
| Rate for Payer: Nomi Health Commercial |
$756.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$808.08
|
| Rate for Payer: Priority Health Narrow Network |
$646.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.58
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$431.90
|
|
|
Service Code
|
NDC 00406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$172.76 |
| Max. Negotiated Rate |
$431.90 |
| Rate for Payer: Aetna Commercial |
$388.71
|
| Rate for Payer: Aetna Medicare |
$215.95
|
| Rate for Payer: ASR ASR |
$418.94
|
| Rate for Payer: ASR Commercial |
$418.94
|
| Rate for Payer: BCBS Complete |
$172.76
|
| Rate for Payer: BCBS Trust/PPO |
$353.68
|
| Rate for Payer: BCN Commercial |
$334.85
|
| Rate for Payer: Cash Price |
$345.52
|
| Rate for Payer: Cofinity Commercial |
$405.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.52
|
| Rate for Payer: Healthscope Commercial |
$431.90
|
| Rate for Payer: Healthscope Whirlpool |
$418.94
|
| Rate for Payer: Mclaren Commercial |
$388.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.12
|
| Rate for Payer: Nomi Health Commercial |
$354.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$378.43
|
| Rate for Payer: Priority Health Narrow Network |
$302.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$380.07
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$4.24
|
|
|
Service Code
|
NDC 68084040311
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.76 |
| Max. Negotiated Rate |
$4.24 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: ASR ASR |
$4.11
|
| Rate for Payer: ASR Commercial |
$4.11
|
| Rate for Payer: BCBS Trust/PPO |
$3.46
|
| Rate for Payer: BCN Commercial |
$3.29
|
| Rate for Payer: Cash Price |
$3.39
|
| Rate for Payer: Cofinity Commercial |
$3.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.39
|
| Rate for Payer: Healthscope Commercial |
$4.24
|
| Rate for Payer: Healthscope Whirlpool |
$4.11
|
| Rate for Payer: Mclaren Commercial |
$3.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.60
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.73
|
|
