|
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$8,884.86
|
|
|
Service Code
|
APR-DRG 7932
|
| Min. Negotiated Rate |
$8,032.98 |
| Max. Negotiated Rate |
$8,884.86 |
| Rate for Payer: BCBS Complete |
$8,884.86
|
| Rate for Payer: Mclaren Medicaid |
$8,461.78
|
| Rate for Payer: Meridian Medicaid |
$8,884.86
|
| Rate for Payer: PHP Medicaid |
$8,032.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,461.78
|
| Rate for Payer: UHC Medicaid |
$8,461.78
|
| Rate for Payer: UHCCP Medicaid |
$8,461.78
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$6,739.94
|
|
|
Service Code
|
APR-DRG 7931
|
| Min. Negotiated Rate |
$6,093.71 |
| Max. Negotiated Rate |
$6,739.94 |
| Rate for Payer: BCBS Complete |
$6,739.94
|
| Rate for Payer: Mclaren Medicaid |
$6,418.99
|
| Rate for Payer: Meridian Medicaid |
$6,739.94
|
| Rate for Payer: PHP Medicaid |
$6,093.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,418.99
|
| Rate for Payer: UHC Medicaid |
$6,418.99
|
| Rate for Payer: UHCCP Medicaid |
$6,418.99
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$22,429.60
|
|
|
Service Code
|
APR-DRG 7934
|
| Min. Negotiated Rate |
$20,279.04 |
| Max. Negotiated Rate |
$22,429.60 |
| Rate for Payer: BCBS Complete |
$22,429.60
|
| Rate for Payer: Mclaren Medicaid |
$21,361.52
|
| Rate for Payer: Meridian Medicaid |
$22,429.60
|
| Rate for Payer: PHP Medicaid |
$20,279.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$21,361.52
|
| Rate for Payer: UHC Medicaid |
$21,361.52
|
| Rate for Payer: UHCCP Medicaid |
$21,361.52
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
IP
|
$12,858.64
|
|
|
Service Code
|
APR-DRG 7933
|
| Min. Negotiated Rate |
$11,625.75 |
| Max. Negotiated Rate |
$12,858.64 |
| Rate for Payer: BCBS Complete |
$12,858.64
|
| Rate for Payer: Mclaren Medicaid |
$12,246.32
|
| Rate for Payer: Meridian Medicaid |
$12,858.64
|
| Rate for Payer: PHP Medicaid |
$11,625.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,246.32
|
| Rate for Payer: UHC Medicaid |
$12,246.32
|
| Rate for Payer: UHCCP Medicaid |
$12,246.32
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$7,218.95
|
|
|
Service Code
|
APR-DRG 9511
|
| Min. Negotiated Rate |
$6,526.80 |
| Max. Negotiated Rate |
$7,218.95 |
| Rate for Payer: BCBS Complete |
$7,218.95
|
| Rate for Payer: Mclaren Medicaid |
$6,875.19
|
| Rate for Payer: Meridian Medicaid |
$7,218.95
|
| Rate for Payer: PHP Medicaid |
$6,526.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,875.19
|
| Rate for Payer: UHC Medicaid |
$6,875.19
|
| Rate for Payer: UHCCP Medicaid |
$6,875.19
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$21,541.33
|
|
|
Service Code
|
APR-DRG 9514
|
| Min. Negotiated Rate |
$19,475.94 |
| Max. Negotiated Rate |
$21,541.33 |
| Rate for Payer: BCBS Complete |
$21,541.33
|
| Rate for Payer: Mclaren Medicaid |
$20,515.55
|
| Rate for Payer: Meridian Medicaid |
$21,541.33
|
| Rate for Payer: PHP Medicaid |
$19,475.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$20,515.55
|
| Rate for Payer: UHC Medicaid |
$20,515.55
|
| Rate for Payer: UHCCP Medicaid |
$20,515.55
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$13,205.23
|
|
|
Service Code
|
APR-DRG 9513
|
| Min. Negotiated Rate |
$11,939.11 |
| Max. Negotiated Rate |
$13,205.23 |
| Rate for Payer: BCBS Complete |
$13,205.23
|
| Rate for Payer: Mclaren Medicaid |
$12,576.41
|
| Rate for Payer: Meridian Medicaid |
$13,205.23
|
| Rate for Payer: PHP Medicaid |
$11,939.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$12,576.41
|
| Rate for Payer: UHC Medicaid |
$12,576.41
|
| Rate for Payer: UHCCP Medicaid |
$12,576.41
|
|
|
MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS
|
Facility
|
IP
|
$9,561.69
|
|
|
Service Code
|
APR-DRG 9512
|
| Min. Negotiated Rate |
$8,644.91 |
| Max. Negotiated Rate |
$9,561.69 |
| Rate for Payer: BCBS Complete |
$9,561.69
|
| Rate for Payer: Mclaren Medicaid |
$9,106.37
|
| Rate for Payer: Meridian Medicaid |
$9,561.69
|
| Rate for Payer: PHP Medicaid |
$8,644.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,106.37
|
| Rate for Payer: UHC Medicaid |
$9,106.37
|
| Rate for Payer: UHCCP Medicaid |
$9,106.37
|
|
|
MOLASSES
|
Facility
|
IP
|
$23.94
|
|
|
Service Code
|
NDC 990000075
|
| Hospital Charge Code |
500563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$23.94 |
| Rate for Payer: Aetna Commercial |
$21.55
|
| Rate for Payer: ASR ASR |
$23.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.66
|
| Rate for Payer: BCN Commercial |
$19.66
|
| Rate for Payer: Cash Price |
$19.15
|
| Rate for Payer: Cofinity Commercial |
$22.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.15
|
| Rate for Payer: Healthscope Commercial |
$23.22
|
| Rate for Payer: Healthscope Whirlpool |
$23.94
|
| Rate for Payer: Mclaren Commercial |
$21.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.35
|
| Rate for Payer: Nomi Health Commercial |
$19.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.07
|
|
|
MOLASSES
|
Facility
|
IP
|
$6.48
|
|
|
Service Code
|
NDC 9900001118
|
| Hospital Charge Code |
500563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: ASR ASR |
$6.29
|
| Rate for Payer: BCBS Trust/PPO |
$5.32
|
| Rate for Payer: BCN Commercial |
$5.32
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$6.29
|
| Rate for Payer: Healthscope Whirlpool |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$5.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.51
|
| Rate for Payer: Nomi Health Commercial |
$5.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.70
|
|
|
MOLASSES
|
Facility
|
OP
|
$23.94
|
|
|
Service Code
|
NDC 990000075
|
| Hospital Charge Code |
500563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$23.94 |
| Rate for Payer: Aetna Commercial |
$21.55
|
| Rate for Payer: Aetna Medicare |
$8.86
|
| Rate for Payer: ASR ASR |
$23.22
|
| Rate for Payer: BCBS Complete |
$9.58
|
| Rate for Payer: BCBS Trust/PPO |
$19.74
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: Cash Price |
$19.15
|
| Rate for Payer: Cofinity Commercial |
$22.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.15
|
| Rate for Payer: Healthscope Commercial |
$23.22
|
| Rate for Payer: Healthscope Whirlpool |
$23.94
|
| Rate for Payer: Mclaren Commercial |
$21.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.35
|
| Rate for Payer: Nomi Health Commercial |
$19.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$20.98
|
| Rate for Payer: Priority Health Narrow Network |
$16.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.07
|
|
|
MOLASSES
|
Facility
|
OP
|
$6.48
|
|
|
Service Code
|
NDC 9900001118
|
| Hospital Charge Code |
500563
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$6.48 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: Aetna Medicare |
$2.40
|
| Rate for Payer: ASR ASR |
$6.29
|
| Rate for Payer: BCBS Complete |
$2.59
|
| Rate for Payer: BCBS Trust/PPO |
$5.34
|
| Rate for Payer: BCN Commercial |
$5.34
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$6.29
|
| Rate for Payer: Healthscope Whirlpool |
$6.48
|
| Rate for Payer: Mclaren Commercial |
$5.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.51
|
| Rate for Payer: Nomi Health Commercial |
$5.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.68
|
| Rate for Payer: Priority Health Narrow Network |
$4.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.70
|
|
|
MONALISA TOUCH, SERIES, UP TO 3 VISITS
|
Professional
|
Both
|
$1,891.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$756.40 |
| Max. Negotiated Rate |
$1,418.25 |
| Rate for Payer: BCBS Complete |
$756.40
|
| Rate for Payer: Cash Price |
$1,512.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,418.25
|
|
|
MONALISA TOUCH, SINGLE TREATMENT FOLLOWING A SERIES
|
Professional
|
Both
|
$630.00
|
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$252.00 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: BCBS Complete |
$252.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
|
|
MONTELUKAST 10 MG TABLET
|
Facility
|
IP
|
$238.45
|
|
|
Service Code
|
NDC 904680861
|
| Hospital Charge Code |
22509
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$178.84 |
| Max. Negotiated Rate |
$238.45 |
| Rate for Payer: Aetna Commercial |
$214.60
|
| Rate for Payer: ASR ASR |
$231.30
|
| Rate for Payer: BCBS Trust/PPO |
$195.82
|
| Rate for Payer: BCN Commercial |
$195.82
|
| Rate for Payer: Cash Price |
$190.76
|
| Rate for Payer: Cofinity Commercial |
$224.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.76
|
| Rate for Payer: Healthscope Commercial |
$231.30
|
| Rate for Payer: Healthscope Whirlpool |
$238.45
|
| Rate for Payer: Mclaren Commercial |
$214.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.68
|
| Rate for Payer: Nomi Health Commercial |
$195.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.84
|
|
|
MONTELUKAST 10 MG TABLET
|
Facility
|
OP
|
$238.45
|
|
|
Service Code
|
NDC 904680861
|
| Hospital Charge Code |
22509
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$88.23 |
| Max. Negotiated Rate |
$238.45 |
| Rate for Payer: Aetna Commercial |
$214.60
|
| Rate for Payer: Aetna Medicare |
$88.23
|
| Rate for Payer: ASR ASR |
$231.30
|
| Rate for Payer: BCBS Complete |
$95.38
|
| Rate for Payer: BCBS Trust/PPO |
$196.60
|
| Rate for Payer: BCN Commercial |
$196.60
|
| Rate for Payer: Cash Price |
$190.76
|
| Rate for Payer: Cofinity Commercial |
$224.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.76
|
| Rate for Payer: Healthscope Commercial |
$231.30
|
| Rate for Payer: Healthscope Whirlpool |
$238.45
|
| Rate for Payer: Mclaren Commercial |
$214.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$190.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.68
|
| Rate for Payer: Nomi Health Commercial |
$195.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$208.93
|
| Rate for Payer: Priority Health Narrow Network |
$167.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$209.84
|
|
|
MORPHINE 10 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$17.46
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
27390
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.52 |
| Max. Negotiated Rate |
$17.46 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: Aetna Medicare |
$6.46
|
| Rate for Payer: ASR ASR |
$16.94
|
| Rate for Payer: BCBS Complete |
$6.99
|
| Rate for Payer: BCBS Trust/PPO |
$14.40
|
| Rate for Payer: BCN Commercial |
$14.40
|
| Rate for Payer: Cash Price |
$13.97
|
| Rate for Payer: Cash Price |
$13.97
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.97
|
| Rate for Payer: Healthscope Commercial |
$16.94
|
| Rate for Payer: Healthscope Whirlpool |
$17.46
|
| Rate for Payer: Mclaren Commercial |
$15.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.84
|
| Rate for Payer: Nomi Health Commercial |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| Rate for Payer: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.37
|
|
|
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 |
$13.10 |
| Max. Negotiated Rate |
$17.46 |
| Rate for Payer: Aetna Commercial |
$15.72
|
| Rate for Payer: ASR ASR |
$16.94
|
| Rate for Payer: BCBS Trust/PPO |
$14.34
|
| Rate for Payer: BCN Commercial |
$14.34
|
| Rate for Payer: Cash Price |
$13.97
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.97
|
| Rate for Payer: Healthscope Commercial |
$16.94
|
| Rate for Payer: Healthscope Whirlpool |
$17.46
|
| Rate for Payer: Mclaren Commercial |
$15.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.84
|
| Rate for Payer: Nomi Health Commercial |
$14.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.37
|
|
|
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 |
$12.39 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: BCBS Trust/PPO |
$13.57
|
| Rate for Payer: BCN Commercial |
$13.57
|
| 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 |
$16.02
|
| Rate for Payer: Healthscope Whirlpool |
$16.52
|
| 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: Opus (Opus Packaging Group) HMA |
$12.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
|
|
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 |
$2.52 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna Commercial |
$14.87
|
| Rate for Payer: Aetna Medicare |
$6.11
|
| Rate for Payer: ASR ASR |
$16.02
|
| Rate for Payer: BCBS Complete |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$13.62
|
| Rate for Payer: BCN Commercial |
$13.62
|
| 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 |
$16.02
|
| Rate for Payer: Healthscope Whirlpool |
$16.52
|
| Rate for Payer: Mclaren Commercial |
$14.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.04
|
| Rate for Payer: Nomi Health Commercial |
$13.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| Rate for Payer: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.54
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
IP
|
$123.38
|
|
|
Service Code
|
NDC 54023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$92.53 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: BCBS Trust/PPO |
$101.32
|
| Rate for Payer: BCN Commercial |
$101.32
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$119.67
|
| Rate for Payer: Healthscope Whirlpool |
$123.38
|
| 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: Opus (Opus Packaging Group) HMA |
$92.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$108.57
|
|
|
MORPHINE 15 MG IMMEDIATE RELEASE TABLET
|
Facility
|
OP
|
$123.38
|
|
|
Service Code
|
NDC 54023524
|
| Hospital Charge Code |
5178
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$45.65 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna Commercial |
$111.04
|
| Rate for Payer: Aetna Medicare |
$45.65
|
| Rate for Payer: ASR ASR |
$119.67
|
| Rate for Payer: BCBS Complete |
$49.35
|
| Rate for Payer: BCBS Trust/PPO |
$101.72
|
| Rate for Payer: BCN Commercial |
$101.72
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cofinity Commercial |
$115.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.70
|
| Rate for Payer: Healthscope Commercial |
$119.67
|
| Rate for Payer: Healthscope Whirlpool |
$123.38
|
| Rate for Payer: Mclaren Commercial |
$111.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.87
|
| Rate for Payer: Nomi Health Commercial |
$101.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$108.10
|
| 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 |
$20.06 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: BCBS Trust/PPO |
$21.97
|
| Rate for Payer: BCN Commercial |
$21.97
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$25.95
|
| Rate for Payer: Healthscope Whirlpool |
$26.75
|
| 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: Opus (Opus Packaging Group) HMA |
$20.06
|
| 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 |
$2.52 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: Aetna Medicare |
$9.90
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS Trust/PPO |
$22.06
|
| Rate for Payer: BCN Commercial |
$22.06
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$25.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Healthscope Commercial |
$25.95
|
| Rate for Payer: Healthscope Whirlpool |
$26.75
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| Rate for Payer: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
|
|
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 |
$23.10 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: ASR ASR |
$29.88
|
| Rate for Payer: BCBS Trust/PPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$25.30
|
| 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 |
$29.88
|
| Rate for Payer: Healthscope Whirlpool |
$30.80
|
| 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: Opus (Opus Packaging Group) HMA |
$23.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.11
|
|
