|
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 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 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 |
$866.91
|
| 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 |
$756.25
|
| 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
|
IP
|
$424.20
|
|
|
Service Code
|
NDC 68084040301
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$275.73 |
| Max. Negotiated Rate |
$424.20 |
| Rate for Payer: Aetna Commercial |
$381.78
|
| Rate for Payer: ASR ASR |
$411.47
|
| Rate for Payer: ASR Commercial |
$411.47
|
| Rate for Payer: BCBS Trust/PPO |
$345.68
|
| Rate for Payer: BCN Commercial |
$328.88
|
| Rate for Payer: Cash Price |
$339.36
|
| Rate for Payer: Cofinity Commercial |
$398.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.36
|
| Rate for Payer: Healthscope Commercial |
$424.20
|
| Rate for Payer: Healthscope Whirlpool |
$411.47
|
| Rate for Payer: Mclaren Commercial |
$381.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.57
|
| Rate for Payer: Nomi Health Commercial |
$347.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.30
|
|
|
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
|
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
|
$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
|
$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
|
$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
|
OP
|
$4.24
|
|
|
Service Code
|
NDC 68084040311
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$4.24 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: Aetna Medicare |
$2.12
|
| Rate for Payer: ASR ASR |
$4.11
|
| Rate for Payer: ASR Commercial |
$4.11
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS Trust/PPO |
$3.47
|
| 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: Priority Health HMO/PPO/Tiered Network |
$3.72
|
| Rate for Payer: Priority Health Narrow Network |
$2.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.73
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$922.25
|
|
|
Service Code
|
NDC 00904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$599.46 |
| Max. Negotiated Rate |
$922.25 |
| Rate for Payer: Aetna Commercial |
$830.02
|
| Rate for Payer: ASR ASR |
$894.58
|
| Rate for Payer: ASR Commercial |
$894.58
|
| Rate for Payer: BCBS Trust/PPO |
$751.54
|
| Rate for Payer: BCN Commercial |
$715.02
|
| Rate for Payer: Cash Price |
$737.80
|
| Rate for Payer: Cofinity Commercial |
$866.91
|
| 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 |
$756.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$811.58
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$5.11
|
|
|
Service Code
|
NDC 00406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.32 |
| Max. Negotiated Rate |
$5.11 |
| Rate for Payer: Aetna Commercial |
$4.60
|
| Rate for Payer: ASR ASR |
$4.96
|
| Rate for Payer: ASR Commercial |
$4.96
|
| Rate for Payer: BCBS Trust/PPO |
$4.16
|
| 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: UHC All Payor (Choice/PPO) + Core |
$4.50
|
|
|
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
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$424.20
|
|
|
Service Code
|
NDC 68084040301
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$169.68 |
| Max. Negotiated Rate |
$424.20 |
| Rate for Payer: Aetna Commercial |
$381.78
|
| Rate for Payer: Aetna Medicare |
$212.10
|
| Rate for Payer: ASR ASR |
$411.47
|
| Rate for Payer: ASR Commercial |
$411.47
|
| Rate for Payer: BCBS Complete |
$169.68
|
| Rate for Payer: BCBS Trust/PPO |
$347.38
|
| Rate for Payer: BCN Commercial |
$328.88
|
| Rate for Payer: Cash Price |
$339.36
|
| Rate for Payer: Cofinity Commercial |
$398.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$339.36
|
| Rate for Payer: Healthscope Commercial |
$424.20
|
| Rate for Payer: Healthscope Whirlpool |
$411.47
|
| Rate for Payer: Mclaren Commercial |
$381.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.57
|
| Rate for Payer: Nomi Health Commercial |
$347.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$275.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$371.68
|
| Rate for Payer: Priority Health Narrow Network |
$297.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.30
|
|
|
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
|
IP
|
$431.90
|
|
|
Service Code
|
NDC 00406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$280.74 |
| Max. Negotiated Rate |
$431.90 |
| Rate for Payer: Aetna Commercial |
$388.71
|
| Rate for Payer: ASR ASR |
$418.94
|
| Rate for Payer: ASR Commercial |
$418.94
|
| Rate for Payer: BCBS Trust/PPO |
$351.96
|
| 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: UHC All Payor (Choice/PPO) + Core |
$380.07
|
|
|
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 |
$512.78 |
| Max. Negotiated Rate |
$788.90 |
| Rate for Payer: Aetna Commercial |
$710.01
|
| Rate for Payer: ASR ASR |
$765.23
|
| Rate for Payer: ASR Commercial |
$765.23
|
| Rate for Payer: BCBS Trust/PPO |
$642.87
|
| Rate for Payer: BCN Commercial |
$611.63
|
| Rate for Payer: Cash Price |
$631.12
|
| Rate for Payer: Cofinity Commercial |
$741.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.12
|
| Rate for Payer: Healthscope Commercial |
$788.90
|
| Rate for Payer: Healthscope Whirlpool |
$765.23
|
| Rate for Payer: Mclaren Commercial |
$710.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.57
|
| Rate for Payer: Nomi Health Commercial |
$646.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.23
|
|
|
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 |
$315.56 |
| Max. Negotiated Rate |
$788.90 |
| Rate for Payer: Aetna Commercial |
$710.01
|
| Rate for Payer: Aetna Medicare |
$394.45
|
| Rate for Payer: ASR ASR |
$765.23
|
| Rate for Payer: ASR Commercial |
$765.23
|
| Rate for Payer: BCBS Complete |
$315.56
|
| Rate for Payer: BCBS Trust/PPO |
$646.03
|
| Rate for Payer: BCN Commercial |
$611.63
|
| Rate for Payer: Cash Price |
$631.12
|
| Rate for Payer: Cofinity Commercial |
$741.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$631.12
|
| Rate for Payer: Healthscope Commercial |
$788.90
|
| Rate for Payer: Healthscope Whirlpool |
$765.23
|
| Rate for Payer: Mclaren Commercial |
$710.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$670.57
|
| Rate for Payer: Nomi Health Commercial |
$646.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$512.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$691.23
|
| Rate for Payer: Priority Health Narrow Network |
$553.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$694.23
|
|
|
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 |
$5.13 |
| Max. Negotiated Rate |
$7.89 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: ASR ASR |
$7.65
|
| Rate for Payer: ASR Commercial |
$7.65
|
| Rate for Payer: BCBS Trust/PPO |
$6.43
|
| Rate for Payer: BCN Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$7.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$7.89
|
| Rate for Payer: Healthscope Whirlpool |
$7.65
|
| Rate for Payer: Mclaren Commercial |
$7.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$717.50
|
|
|
Service Code
|
NDC 00904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$466.38 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna Commercial |
$645.75
|
| Rate for Payer: ASR ASR |
$695.98
|
| Rate for Payer: ASR Commercial |
$695.98
|
| Rate for Payer: BCBS Trust/PPO |
$584.69
|
| Rate for Payer: BCN Commercial |
$556.28
|
| Rate for Payer: Cash Price |
$574.00
|
| Rate for Payer: Cofinity Commercial |
$674.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.00
|
| Rate for Payer: Healthscope Commercial |
$717.50
|
| Rate for Payer: Healthscope Whirlpool |
$695.98
|
| Rate for Payer: Mclaren Commercial |
$645.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$609.88
|
| Rate for Payer: Nomi Health Commercial |
$588.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.40
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$7.89
|
|
|
Service Code
|
NDC 00406833023
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$7.89 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare |
$3.94
|
| Rate for Payer: ASR ASR |
$7.65
|
| Rate for Payer: ASR Commercial |
$7.65
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.12
|
| Rate for Payer: Cash Price |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$7.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.31
|
| Rate for Payer: Healthscope Commercial |
$7.89
|
| Rate for Payer: Healthscope Whirlpool |
$7.65
|
| Rate for Payer: Mclaren Commercial |
$7.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.71
|
| Rate for Payer: Nomi Health Commercial |
$6.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.91
|
| Rate for Payer: Priority Health Narrow Network |
$5.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.94
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$717.50
|
|
|
Service Code
|
NDC 00904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$287.00 |
| Max. Negotiated Rate |
$717.50 |
| Rate for Payer: Aetna Commercial |
$645.75
|
| Rate for Payer: Aetna Medicare |
$358.75
|
| Rate for Payer: ASR ASR |
$695.98
|
| Rate for Payer: ASR Commercial |
$695.98
|
| Rate for Payer: BCBS Complete |
$287.00
|
| Rate for Payer: BCBS Trust/PPO |
$587.56
|
| Rate for Payer: BCN Commercial |
$556.28
|
| Rate for Payer: Cash Price |
$574.00
|
| Rate for Payer: Cofinity Commercial |
$674.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$574.00
|
| Rate for Payer: Healthscope Commercial |
$717.50
|
| Rate for Payer: Healthscope Whirlpool |
$695.98
|
| Rate for Payer: Mclaren Commercial |
$645.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$609.88
|
| Rate for Payer: Nomi Health Commercial |
$588.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$466.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.67
|
| Rate for Payer: Priority Health Narrow Network |
$502.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$631.40
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
OP
|
$11.62
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$11.62 |
| Rate for Payer: Aetna Commercial |
$10.46
|
| Rate for Payer: Aetna Medicare |
$5.81
|
| Rate for Payer: ASR ASR |
$11.27
|
| Rate for Payer: ASR Commercial |
$11.27
|
| Rate for Payer: BCBS Complete |
$4.65
|
| Rate for Payer: BCBS Trust/PPO |
$9.52
|
| Rate for Payer: BCN Commercial |
$9.01
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cofinity Commercial |
$10.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$11.62
|
| Rate for Payer: Healthscope Whirlpool |
$11.27
|
| Rate for Payer: Mclaren Commercial |
$10.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: Nomi Health Commercial |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.18
|
| Rate for Payer: Priority Health Narrow Network |
$8.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.23
|
|
|
MORPHINE INHALATION (VARIABLE DOSE)
|
Facility
|
IP
|
$11.62
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
300139
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$11.62 |
| Rate for Payer: Aetna Commercial |
$10.46
|
| Rate for Payer: ASR ASR |
$11.27
|
| Rate for Payer: ASR Commercial |
$11.27
|
| Rate for Payer: BCBS Trust/PPO |
$9.47
|
| Rate for Payer: BCN Commercial |
$9.01
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cofinity Commercial |
$10.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$11.62
|
| Rate for Payer: Healthscope Whirlpool |
$11.27
|
| Rate for Payer: Mclaren Commercial |
$10.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.88
|
| Rate for Payer: Nomi Health Commercial |
$9.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.23
|
|
|
MORPHINE (PF) 1 MG/ML INJECTION SOLUTION
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
HCPCS J2274
|
| Hospital Charge Code |
15852
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.59 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Commercial |
$121.09
|
| Rate for Payer: ASR ASR |
$130.51
|
| Rate for Payer: ASR ASR |
$41.18
|
| Rate for Payer: ASR Commercial |
$130.51
|
| Rate for Payer: ASR Commercial |
$41.18
|
| Rate for Payer: BCBS Trust/PPO |
$109.64
|
| Rate for Payer: BCBS Trust/PPO |
$34.59
|
| Rate for Payer: BCN Commercial |
$32.91
|
| Rate for Payer: BCN Commercial |
$104.32
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$107.64
|
| Rate for Payer: Cofinity Commercial |
$126.48
|
| Rate for Payer: Cofinity Commercial |
$39.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$134.55
|
| Rate for Payer: Healthscope Commercial |
$42.45
|
| Rate for Payer: Healthscope Whirlpool |
$41.18
|
| Rate for Payer: Healthscope Whirlpool |
$130.51
|
| Rate for Payer: Mclaren Commercial |
$121.09
|
| Rate for Payer: Mclaren Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.37
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: Nomi Health Commercial |
$110.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$118.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.36
|
|
