|
MORPHINE 10 MG/5 ML ORAL SOLN
|
Facility
|
IP
|
$4.09
|
|
|
Service Code
|
NDC 54023749
|
| Hospital Charge Code |
60627714
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$0.61 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.61
|
|
|
MORPHINE 10MG/ML
|
Facility
|
IP
|
$7.70
|
|
| Hospital Charge Code |
6012074
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
|
|
MORPHINE 10MG/ML
|
Facility
|
OP
|
$7.70
|
|
| Hospital Charge Code |
6012074
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3.85 |
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: Aetna Medicare Advantage |
$2.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.96
|
| Rate for Payer: Cigna Commercial |
$3.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.00
|
| Rate for Payer: Oxford Commercial |
$3.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.85
|
|
|
MORPHINE 10 MG/ML INJ
|
Facility
|
OP
|
$8.04
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60627713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$4.45 |
| Rate for Payer: Aetna Commercial |
$2.41
|
| Rate for Payer: Aetna Medicare Advantage |
$2.41
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.05
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.05
|
| Rate for Payer: Cigna Commercial |
$4.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
|
|
MORPHINE 10 MG/ML INJ
|
Facility
|
IP
|
$8.04
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60627713
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$1.95 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.21
|
|
|
MORPHINE 15 MG ER TAB
|
Facility
|
OP
|
$4.00
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
60627715
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Aetna Commercial |
$1.20
|
| Rate for Payer: Aetna Medicare Advantage |
$1.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.02
|
| Rate for Payer: Cigna Commercial |
$2.00
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.52
|
| Rate for Payer: Oxford Commercial |
$2.00
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.00
|
|
|
MORPHINE 15 MG ER TAB
|
Facility
|
IP
|
$4.00
|
|
|
Service Code
|
NDC 42858080101
|
| Hospital Charge Code |
60627715
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.60
|
|
|
MORPHINE 15MG/ML
|
Facility
|
IP
|
$7.70
|
|
| Hospital Charge Code |
6012082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
|
|
MORPHINE 15MG/ML
|
Facility
|
OP
|
$7.70
|
|
| Hospital Charge Code |
6012082
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$3.85 |
| Rate for Payer: Aetna Commercial |
$2.31
|
| Rate for Payer: Aetna Medicare Advantage |
$2.31
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.96
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.96
|
| Rate for Payer: Cigna Commercial |
$3.85
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.00
|
| Rate for Payer: Oxford Commercial |
$3.85
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.85
|
|
|
MORPHINE 15 MG/ML INJ
|
Facility
|
IP
|
$10.45
|
|
| Hospital Charge Code |
60627716
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.57
|
|
|
MORPHINE 15 MG/ML INJ
|
Facility
|
OP
|
$10.45
|
|
| Hospital Charge Code |
60627716
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$5.22 |
| Rate for Payer: Aetna Commercial |
$3.13
|
| Rate for Payer: Aetna Medicare Advantage |
$3.13
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.66
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.66
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.53
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.57
|
|
|
MORPHINE 15 MG TAB
|
Facility
|
IP
|
$6.10
|
|
|
Service Code
|
NDC 54023524
|
| Hospital Charge Code |
60629965
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.92
|
|
|
MORPHINE 15 MG TAB
|
Facility
|
OP
|
$6.10
|
|
|
Service Code
|
NDC 54023524
|
| Hospital Charge Code |
60629965
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$3.05 |
| Rate for Payer: Aetna Commercial |
$1.83
|
| Rate for Payer: Aetna Medicare Advantage |
$1.83
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$1.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$1.56
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$1.56
|
| Rate for Payer: Cigna Commercial |
$3.05
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$0.79
|
| Rate for Payer: Oxford Commercial |
$3.05
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$0.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.05
|
|
|
MORPHINE 1MG/1ML INJ 10ML VIAL
|
Facility
|
IP
|
$61.77
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
6003826
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.27 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.27
|
|
|
MORPHINE 1MG/1ML INJ 10ML VIAL
|
Facility
|
OP
|
$61.77
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
6003826
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.45 |
| Max. Negotiated Rate |
$18.53 |
| Rate for Payer: Aetna Commercial |
$18.53
|
| Rate for Payer: Aetna Medicare Advantage |
$18.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$15.75
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$15.75
|
| Rate for Payer: Cigna Commercial |
$4.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$14.95
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$9.27
|
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
OP
|
$13.13
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60627717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$4.45 |
| Rate for Payer: Aetna Commercial |
$3.94
|
| Rate for Payer: Aetna Medicare Advantage |
$3.94
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$3.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$3.35
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$3.35
|
| Rate for Payer: Cigna Commercial |
$4.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.97
|
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
IP
|
$13.13
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60627717
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.97 |
| Max. Negotiated Rate |
$3.18 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$3.18
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.97
|
|
|
MORPHINE 30 MG ER TAB
|
Facility
|
OP
|
$22.65
|
|
|
Service Code
|
NDC 406833023
|
| Hospital Charge Code |
6009856
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$11.32 |
| Rate for Payer: Aetna Commercial |
$6.79
|
| Rate for Payer: Aetna Medicare Advantage |
$6.79
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$5.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$5.78
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$5.78
|
| Rate for Payer: Cigna Commercial |
$11.32
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$2.94
|
| Rate for Payer: Oxford Commercial |
$11.32
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.32
|
|
|
MORPHINE 30 MG ER TAB
|
Facility
|
IP
|
$22.65
|
|
|
Service Code
|
NDC 406833023
|
| Hospital Charge Code |
6009856
|
|
Hospital Revenue Code
|
251
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$3.40 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$3.40
|
|
|
MORPHINE 30MG IR TAB
|
Facility
|
IP
|
$10.32
|
|
|
Service Code
|
NDC 54023624
|
| Hospital Charge Code |
60630164
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.55 |
| Max. Negotiated Rate |
$1.55 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.55
|
|
|
MORPHINE 30MG IR TAB
|
Facility
|
OP
|
$10.32
|
|
|
Service Code
|
NDC 54023624
|
| Hospital Charge Code |
60630164
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.34 |
| Max. Negotiated Rate |
$5.16 |
| Rate for Payer: Aetna Commercial |
$3.10
|
| Rate for Payer: Aetna Medicare Advantage |
$3.10
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.63
|
| Rate for Payer: Cigna Commercial |
$5.16
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.34
|
| Rate for Payer: Oxford Commercial |
$5.16
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.55
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.16
|
|
|
MORPHINE 4 MG INJ
|
Facility
|
OP
|
$7.91
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60639164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$4.45 |
| Rate for Payer: Aetna Commercial |
$2.37
|
| Rate for Payer: Aetna Medicare Advantage |
$2.37
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$2.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$2.02
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$2.02
|
| Rate for Payer: Cigna Commercial |
$4.45
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.19
|
|
|
MORPHINE 4 MG INJ
|
Facility
|
IP
|
$7.91
|
|
|
Service Code
|
HCPCS J2270
|
| Hospital Charge Code |
60639164
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$1.91
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$1.19
|
|
|
MORPHINE 500MG/20ML PF INJ
|
Facility
|
IP
|
$718.45
|
|
| Hospital Charge Code |
60628822
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$107.77 |
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.77
|
|
|
MORPHINE 500MG/20ML PF INJ
|
Facility
|
OP
|
$718.45
|
|
| Hospital Charge Code |
60628822
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$93.40 |
| Max. Negotiated Rate |
$359.23 |
| Rate for Payer: Aetna Commercial |
$215.53
|
| Rate for Payer: Aetna Medicare Advantage |
$215.53
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity |
$183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care |
$183.20
|
| Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO |
$183.20
|
| Rate for Payer: Cigna Commercial |
$359.23
|
| Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC |
$93.40
|
| Rate for Payer: Oxford Commercial |
$359.23
|
| Rate for Payer: Qualcare PPO/HMO/WC |
$107.77
|
| Rate for Payer: UnitedHealthcare Commercial |
$359.23
|
|