|
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 |
$5.62 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna Commercial |
$27.72
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: ASR ASR |
$29.88
|
| Rate for Payer: BCBS Complete |
$12.32
|
| Rate for Payer: BCBS Trust/PPO |
$25.40
|
| Rate for Payer: BCN Commercial |
$25.40
|
| 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 |
$29.88
|
| Rate for Payer: Healthscope Whirlpool |
$30.80
|
| Rate for Payer: Mclaren Commercial |
$27.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.64
|
| 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: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7.03
|
| Rate for Payer: Priority Health Narrow Network |
$5.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.11
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$18.83
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$18.83 |
| Rate for Payer: Aetna Commercial |
$16.95
|
| Rate for Payer: Aetna Commercial |
$14.57
|
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: Aetna Commercial |
$14.29
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: ASR ASR |
$18.27
|
| Rate for Payer: ASR ASR |
$15.71
|
| Rate for Payer: ASR ASR |
$15.41
|
| Rate for Payer: BCBS Trust/PPO |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$13.04
|
| Rate for Payer: BCBS Trust/PPO |
$13.30
|
| Rate for Payer: BCBS Trust/PPO |
$21.97
|
| Rate for Payer: BCN Commercial |
$13.04
|
| Rate for Payer: BCN Commercial |
$21.97
|
| Rate for Payer: BCN Commercial |
$13.30
|
| Rate for Payer: BCN Commercial |
$15.46
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$15.06
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$25.15
|
| Rate for Payer: Cofinity Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.71
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$25.95
|
| Rate for Payer: Healthscope Whirlpool |
$18.83
|
| Rate for Payer: Healthscope Whirlpool |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$15.88
|
| Rate for Payer: Healthscope Whirlpool |
$16.19
|
| Rate for Payer: Mclaren Commercial |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: Mclaren Commercial |
$14.57
|
| Rate for Payer: Mclaren Commercial |
$16.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Nomi Health Commercial |
$13.28
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Nomi Health Commercial |
$15.44
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.25
|
| 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 |
$2.52 |
| Max. Negotiated Rate |
$26.75 |
| Rate for Payer: Aetna Commercial |
$24.08
|
| Rate for Payer: Aetna Commercial |
$14.57
|
| Rate for Payer: Aetna Commercial |
$16.95
|
| Rate for Payer: Aetna Commercial |
$14.29
|
| Rate for Payer: Aetna Medicare |
$5.88
|
| Rate for Payer: Aetna Medicare |
$9.90
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: ASR ASR |
$18.27
|
| Rate for Payer: ASR ASR |
$15.71
|
| Rate for Payer: ASR ASR |
$15.41
|
| Rate for Payer: ASR ASR |
$25.95
|
| Rate for Payer: BCBS Complete |
$7.53
|
| Rate for Payer: BCBS Complete |
$6.35
|
| Rate for Payer: BCBS Complete |
$10.70
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$13.35
|
| Rate for Payer: BCBS Trust/PPO |
$22.06
|
| Rate for Payer: BCBS Trust/PPO |
$15.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.10
|
| Rate for Payer: BCN Commercial |
$22.06
|
| Rate for Payer: BCN Commercial |
$15.53
|
| Rate for Payer: BCN Commercial |
$13.10
|
| Rate for Payer: BCN Commercial |
$13.35
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cash Price |
$15.06
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$12.71
|
| Rate for Payer: Cash Price |
$21.40
|
| Rate for Payer: Cash Price |
$15.06
|
| Rate for Payer: Cofinity Commercial |
$25.15
|
| Rate for Payer: Cofinity Commercial |
$14.93
|
| Rate for Payer: Cofinity Commercial |
$17.70
|
| Rate for Payer: Cofinity Commercial |
$15.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.06
|
| Rate for Payer: Healthscope Commercial |
$25.95
|
| Rate for Payer: Healthscope Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$15.71
|
| Rate for Payer: Healthscope Commercial |
$18.27
|
| Rate for Payer: Healthscope Whirlpool |
$15.88
|
| Rate for Payer: Healthscope Whirlpool |
$18.83
|
| Rate for Payer: Healthscope Whirlpool |
$26.75
|
| Rate for Payer: Healthscope Whirlpool |
$16.19
|
| Rate for Payer: Mclaren Commercial |
$16.95
|
| Rate for Payer: Mclaren Commercial |
$14.57
|
| Rate for Payer: Mclaren Commercial |
$14.29
|
| Rate for Payer: Mclaren Commercial |
$24.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.74
|
| Rate for Payer: Nomi Health Commercial |
$13.02
|
| Rate for Payer: Nomi Health Commercial |
$15.44
|
| Rate for Payer: Nomi Health Commercial |
$21.94
|
| Rate for Payer: Nomi Health Commercial |
$13.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.15
|
| 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: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: Priority Health Narrow Network |
$2.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$16.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$23.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.25
|
|
|
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 |
$5.62 |
| Max. Negotiated Rate |
$25.97 |
| Rate for Payer: Aetna Commercial |
$23.38
|
| Rate for Payer: Aetna Commercial |
$15.29
|
| Rate for Payer: Aetna Medicare |
$6.29
|
| Rate for Payer: Aetna Medicare |
$9.61
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: ASR ASR |
$16.48
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS Complete |
$10.39
|
| Rate for Payer: BCBS Trust/PPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$14.01
|
| Rate for Payer: BCN Commercial |
$14.01
|
| Rate for Payer: BCN Commercial |
$21.42
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$13.59
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$15.97
|
| Rate for Payer: Cofinity Commercial |
$24.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.59
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$16.48
|
| Rate for Payer: Healthscope Whirlpool |
$25.97
|
| Rate for Payer: Healthscope Whirlpool |
$16.99
|
| Rate for Payer: Mclaren Commercial |
$23.38
|
| Rate for Payer: Mclaren Commercial |
$15.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.08
|
| Rate for Payer: Nomi Health Commercial |
$13.93
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$7.03
|
| Rate for Payer: Priority Health Narrow Network |
$5.62
|
| Rate for Payer: Priority Health Narrow Network |
$5.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.86
|
|
|
MORPHINE 4 MG/ML INJECTION SYRINGE
|
Facility
|
IP
|
$16.99
|
|
|
Service Code
|
HCPCS J2272
|
| Hospital Charge Code |
5172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna Commercial |
$15.29
|
| Rate for Payer: Aetna Commercial |
$23.38
|
| Rate for Payer: ASR ASR |
$25.19
|
| Rate for Payer: ASR ASR |
$16.48
|
| Rate for Payer: BCBS Trust/PPO |
$21.33
|
| Rate for Payer: BCBS Trust/PPO |
$13.95
|
| Rate for Payer: BCN Commercial |
$21.33
|
| Rate for Payer: BCN Commercial |
$13.95
|
| Rate for Payer: Cash Price |
$20.78
|
| Rate for Payer: Cash Price |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$15.97
|
| Rate for Payer: Cofinity Commercial |
$24.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.59
|
| Rate for Payer: Healthscope Commercial |
$16.48
|
| Rate for Payer: Healthscope Commercial |
$25.19
|
| Rate for Payer: Healthscope Whirlpool |
$25.97
|
| Rate for Payer: Healthscope Whirlpool |
$16.99
|
| Rate for Payer: Mclaren Commercial |
$23.38
|
| Rate for Payer: Mclaren Commercial |
$15.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.44
|
| Rate for Payer: Nomi Health Commercial |
$21.30
|
| Rate for Payer: Nomi Health Commercial |
$13.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.86
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.44
|
|
|
Service Code
|
NDC 68094004558
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: ASR ASR |
$11.10
|
| Rate for Payer: BCBS Complete |
$4.58
|
| Rate for Payer: BCBS Trust/PPO |
$9.43
|
| Rate for Payer: BCN Commercial |
$9.43
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$10.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$11.10
|
| Rate for Payer: Healthscope Whirlpool |
$11.44
|
| Rate for Payer: Mclaren Commercial |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.02
|
| Rate for Payer: Priority Health Narrow Network |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.07
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
OP
|
$11.44
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: ASR ASR |
$11.10
|
| Rate for Payer: BCBS Complete |
$4.58
|
| Rate for Payer: BCBS Trust/PPO |
$9.43
|
| Rate for Payer: BCN Commercial |
$9.43
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$10.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$11.10
|
| Rate for Payer: Healthscope Whirlpool |
$11.44
|
| Rate for Payer: Mclaren Commercial |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$10.02
|
| Rate for Payer: Priority Health Narrow Network |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.07
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.44
|
|
|
Service Code
|
NDC 68094004501
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.58 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: ASR ASR |
$11.10
|
| Rate for Payer: BCBS Trust/PPO |
$9.39
|
| Rate for Payer: BCN Commercial |
$9.39
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$10.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$11.10
|
| Rate for Payer: Healthscope Whirlpool |
$11.44
|
| Rate for Payer: Mclaren Commercial |
$10.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.07
|
|
|
MORPHINE CONCENTRATE 10 MG/0.5 ML ORAL SYRINGE (FOR ORAL USE ONLY)
|
Facility
|
IP
|
$11.44
|
|
|
Service Code
|
NDC 68094004558
|
| Hospital Charge Code |
189674
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.58 |
| Max. Negotiated Rate |
$11.44 |
| Rate for Payer: Aetna Commercial |
$10.30
|
| Rate for Payer: ASR ASR |
$11.10
|
| Rate for Payer: BCBS Trust/PPO |
$9.39
|
| Rate for Payer: BCN Commercial |
$9.39
|
| Rate for Payer: Cash Price |
$9.15
|
| Rate for Payer: Cofinity Commercial |
$10.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.15
|
| Rate for Payer: Healthscope Commercial |
$11.10
|
| Rate for Payer: Healthscope Whirlpool |
$11.44
|
| Rate for Payer: Mclaren Commercial |
$10.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.72
|
| Rate for Payer: Nomi Health Commercial |
$9.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.07
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$436.10
|
|
|
Service Code
|
NDC 406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$161.36 |
| Max. Negotiated Rate |
$436.10 |
| Rate for Payer: Aetna Commercial |
$392.49
|
| Rate for Payer: Aetna Medicare |
$161.36
|
| Rate for Payer: ASR ASR |
$423.02
|
| Rate for Payer: BCBS Complete |
$174.44
|
| Rate for Payer: BCBS Trust/PPO |
$359.56
|
| Rate for Payer: BCN Commercial |
$359.56
|
| Rate for Payer: Cash Price |
$348.88
|
| Rate for Payer: Cofinity Commercial |
$409.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.88
|
| Rate for Payer: Healthscope Commercial |
$423.02
|
| Rate for Payer: Healthscope Whirlpool |
$436.10
|
| Rate for Payer: Mclaren Commercial |
$392.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.69
|
| Rate for Payer: Nomi Health Commercial |
$357.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$382.11
|
| Rate for Payer: Priority Health Narrow Network |
$305.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.77
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$586.60
|
|
|
Service Code
|
NDC 406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$439.95 |
| Max. Negotiated Rate |
$586.60 |
| Rate for Payer: Aetna Commercial |
$527.94
|
| Rate for Payer: ASR ASR |
$569.00
|
| Rate for Payer: BCBS Trust/PPO |
$481.72
|
| Rate for Payer: BCN Commercial |
$481.72
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Commercial |
$551.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Healthscope Commercial |
$569.00
|
| Rate for Payer: Healthscope Whirlpool |
$586.60
|
| Rate for Payer: Mclaren Commercial |
$527.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Nomi Health Commercial |
$481.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$516.21
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$586.60
|
|
|
Service Code
|
NDC 406831562
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$217.04 |
| Max. Negotiated Rate |
$586.60 |
| Rate for Payer: Aetna Commercial |
$527.94
|
| Rate for Payer: Aetna Medicare |
$217.04
|
| Rate for Payer: ASR ASR |
$569.00
|
| Rate for Payer: BCBS Complete |
$234.64
|
| Rate for Payer: BCBS Trust/PPO |
$483.65
|
| Rate for Payer: BCN Commercial |
$483.65
|
| Rate for Payer: Cash Price |
$469.28
|
| Rate for Payer: Cofinity Commercial |
$551.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$469.28
|
| Rate for Payer: Healthscope Commercial |
$569.00
|
| Rate for Payer: Healthscope Whirlpool |
$586.60
|
| Rate for Payer: Mclaren Commercial |
$527.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$469.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.61
|
| Rate for Payer: Nomi Health Commercial |
$481.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$513.98
|
| Rate for Payer: Priority Health Narrow Network |
$411.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$516.21
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$436.10
|
|
|
Service Code
|
NDC 406831501
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$327.07 |
| Max. Negotiated Rate |
$436.10 |
| Rate for Payer: Aetna Commercial |
$392.49
|
| Rate for Payer: ASR ASR |
$423.02
|
| Rate for Payer: BCBS Trust/PPO |
$358.13
|
| Rate for Payer: BCN Commercial |
$358.13
|
| Rate for Payer: Cash Price |
$348.88
|
| Rate for Payer: Cofinity Commercial |
$409.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$348.88
|
| Rate for Payer: Healthscope Commercial |
$423.02
|
| Rate for Payer: Healthscope Whirlpool |
$436.10
|
| Rate for Payer: Mclaren Commercial |
$392.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$370.69
|
| Rate for Payer: Nomi Health Commercial |
$357.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$327.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.77
|
|
|
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 |
$3.18 |
| Max. Negotiated Rate |
$4.24 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: ASR ASR |
$4.11
|
| Rate for Payer: BCBS Trust/PPO |
$3.48
|
| Rate for Payer: BCN Commercial |
$3.48
|
| 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 |
$4.11
|
| Rate for Payer: Healthscope Whirlpool |
$4.24
|
| Rate for Payer: Mclaren Commercial |
$3.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.61
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.73
|
|
|
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 |
$1.57 |
| Max. Negotiated Rate |
$4.24 |
| Rate for Payer: Aetna Commercial |
$3.82
|
| Rate for Payer: Aetna Medicare |
$1.57
|
| Rate for Payer: ASR ASR |
$4.11
|
| Rate for Payer: BCBS Complete |
$1.70
|
| Rate for Payer: BCBS Trust/PPO |
$3.50
|
| Rate for Payer: BCN Commercial |
$3.50
|
| 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 |
$4.11
|
| Rate for Payer: Healthscope Whirlpool |
$4.24
|
| Rate for Payer: Mclaren Commercial |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.61
|
| Rate for Payer: Nomi Health Commercial |
$3.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.18
|
| Rate for Payer: Priority Health Cigna 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
|
OP
|
$561.75
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$207.85 |
| Max. Negotiated Rate |
$561.75 |
| Rate for Payer: Aetna Commercial |
$505.57
|
| Rate for Payer: Aetna Medicare |
$207.85
|
| Rate for Payer: ASR ASR |
$544.90
|
| Rate for Payer: BCBS Complete |
$224.70
|
| Rate for Payer: BCBS Trust/PPO |
$463.16
|
| Rate for Payer: BCN Commercial |
$463.16
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.40
|
| Rate for Payer: Healthscope Commercial |
$544.90
|
| Rate for Payer: Healthscope Whirlpool |
$561.75
|
| Rate for Payer: Mclaren Commercial |
$505.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.49
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$492.21
|
| Rate for Payer: Priority Health Narrow Network |
$393.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$494.34
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$5.87
|
|
|
Service Code
|
NDC 406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$5.87 |
| Rate for Payer: Aetna Commercial |
$5.28
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: ASR ASR |
$5.69
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS Trust/PPO |
$4.84
|
| Rate for Payer: BCN Commercial |
$4.84
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cofinity Commercial |
$5.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.69
|
| Rate for Payer: Healthscope Commercial |
$5.69
|
| Rate for Payer: Healthscope Whirlpool |
$5.87
|
| Rate for Payer: Mclaren Commercial |
$5.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.99
|
| Rate for Payer: Nomi Health Commercial |
$4.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.14
|
| Rate for Payer: Priority Health Narrow Network |
$4.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.16
|
|
|
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 |
$156.95 |
| Max. Negotiated Rate |
$424.20 |
| Rate for Payer: Aetna Commercial |
$381.78
|
| Rate for Payer: Aetna Medicare |
$156.95
|
| Rate for Payer: ASR ASR |
$411.47
|
| Rate for Payer: BCBS Complete |
$169.68
|
| Rate for Payer: BCBS Trust/PPO |
$349.75
|
| Rate for Payer: BCN Commercial |
$349.75
|
| 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 |
$411.47
|
| Rate for Payer: Healthscope Whirlpool |
$424.20
|
| Rate for Payer: Mclaren Commercial |
$381.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$339.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$360.57
|
| Rate for Payer: Nomi Health Commercial |
$347.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.15
|
| Rate for Payer: Priority Health Cigna 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
|
IP
|
$5.87
|
|
|
Service Code
|
NDC 406831523
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$5.87 |
| Rate for Payer: Aetna Commercial |
$5.28
|
| Rate for Payer: ASR ASR |
$5.69
|
| Rate for Payer: BCBS Trust/PPO |
$4.82
|
| Rate for Payer: BCN Commercial |
$4.82
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cofinity Commercial |
$5.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.69
|
| Rate for Payer: Healthscope Commercial |
$5.69
|
| Rate for Payer: Healthscope Whirlpool |
$5.87
|
| Rate for Payer: Mclaren Commercial |
$5.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.99
|
| Rate for Payer: Nomi Health Commercial |
$4.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.16
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$532.00
|
|
|
Service Code
|
NDC 904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$399.00 |
| Max. Negotiated Rate |
$532.00 |
| Rate for Payer: Aetna Commercial |
$478.80
|
| Rate for Payer: ASR ASR |
$516.04
|
| Rate for Payer: BCBS Trust/PPO |
$436.88
|
| Rate for Payer: BCN Commercial |
$436.88
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$500.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.60
|
| Rate for Payer: Healthscope Commercial |
$516.04
|
| Rate for Payer: Healthscope Whirlpool |
$532.00
|
| Rate for Payer: Mclaren Commercial |
$478.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.20
|
| Rate for Payer: Nomi Health Commercial |
$436.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.16
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$532.00
|
|
|
Service Code
|
NDC 904655761
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$196.84 |
| Max. Negotiated Rate |
$532.00 |
| Rate for Payer: Aetna Commercial |
$478.80
|
| Rate for Payer: Aetna Medicare |
$196.84
|
| Rate for Payer: ASR ASR |
$516.04
|
| Rate for Payer: BCBS Complete |
$212.80
|
| Rate for Payer: BCBS Trust/PPO |
$438.63
|
| Rate for Payer: BCN Commercial |
$438.63
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$500.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.60
|
| Rate for Payer: Healthscope Commercial |
$516.04
|
| Rate for Payer: Healthscope Whirlpool |
$532.00
|
| Rate for Payer: Mclaren Commercial |
$478.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$425.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.20
|
| Rate for Payer: Nomi Health Commercial |
$436.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$399.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$466.14
|
| Rate for Payer: Priority Health Narrow Network |
$372.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$468.16
|
|
|
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 |
$318.15 |
| Max. Negotiated Rate |
$424.20 |
| Rate for Payer: Aetna Commercial |
$381.78
|
| Rate for Payer: ASR ASR |
$411.47
|
| Rate for Payer: BCBS Trust/PPO |
$348.35
|
| Rate for Payer: BCN Commercial |
$348.35
|
| 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 |
$411.47
|
| Rate for Payer: Healthscope Whirlpool |
$424.20
|
| 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: Opus (Opus Packaging Group) HMA |
$318.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$373.30
|
|
|
MORPHINE ER 15 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$561.75
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
20920
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$561.75 |
| Rate for Payer: Aetna Commercial |
$505.57
|
| Rate for Payer: ASR ASR |
$544.90
|
| Rate for Payer: BCBS Trust/PPO |
$461.31
|
| Rate for Payer: BCN Commercial |
$461.31
|
| Rate for Payer: Cash Price |
$449.40
|
| Rate for Payer: Cofinity Commercial |
$528.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$449.40
|
| Rate for Payer: Healthscope Commercial |
$544.90
|
| Rate for Payer: Healthscope Whirlpool |
$561.75
|
| Rate for Payer: Mclaren Commercial |
$505.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$477.49
|
| Rate for Payer: Nomi Health Commercial |
$460.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$421.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$494.34
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
IP
|
$813.40
|
|
|
Service Code
|
NDC 904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$610.05 |
| Max. Negotiated Rate |
$813.40 |
| Rate for Payer: Aetna Commercial |
$732.06
|
| Rate for Payer: ASR ASR |
$789.00
|
| Rate for Payer: BCBS Trust/PPO |
$667.96
|
| Rate for Payer: BCN Commercial |
$667.96
|
| Rate for Payer: Cash Price |
$650.72
|
| Rate for Payer: Cofinity Commercial |
$764.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.72
|
| Rate for Payer: Healthscope Commercial |
$789.00
|
| Rate for Payer: Healthscope Whirlpool |
$813.40
|
| Rate for Payer: Mclaren Commercial |
$732.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.39
|
| Rate for Payer: Nomi Health Commercial |
$666.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$715.79
|
|
|
MORPHINE ER 30 MG TABLET,EXTENDED RELEASE
|
Facility
|
OP
|
$813.40
|
|
|
Service Code
|
NDC 904655861
|
| Hospital Charge Code |
20921
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$300.96 |
| Max. Negotiated Rate |
$813.40 |
| Rate for Payer: Aetna Commercial |
$732.06
|
| Rate for Payer: Aetna Medicare |
$300.96
|
| Rate for Payer: ASR ASR |
$789.00
|
| Rate for Payer: BCBS Complete |
$325.36
|
| Rate for Payer: BCBS Trust/PPO |
$670.65
|
| Rate for Payer: BCN Commercial |
$670.65
|
| Rate for Payer: Cash Price |
$650.72
|
| Rate for Payer: Cofinity Commercial |
$764.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$650.72
|
| Rate for Payer: Healthscope Commercial |
$789.00
|
| Rate for Payer: Healthscope Whirlpool |
$813.40
|
| Rate for Payer: Mclaren Commercial |
$732.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$691.39
|
| Rate for Payer: Nomi Health Commercial |
$666.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$712.70
|
| Rate for Payer: Priority Health Narrow Network |
$570.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$715.79
|
|
