Loma Linda University Behavioral Medicine Center (BMC)

All Charges

Charge

Type

Setting

Price

MORPHINE ER 100 MG TABLET,EXTENDED RELEASE [20919]

Facility

$6.57

Service Code	NDC 0406-8390-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$5.26
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$3.94
Rate for Payer: Aetna of CA Government/Medicare	$3.94
Rate for Payer: Cash Price	$3.61
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$5.26
Rate for Payer: Health Smart Auto/Commercial	$3.94
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$3.94
Rate for Payer: LLUH Dept of Risk Management WC	$3.61
Rate for Payer: Multiplan Commercial	$4.93

MORPHINE ER 100 MG TABLET,EXTENDED RELEASE [20919]

Facility

$6.57

Service Code	NDC 0406-8390-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$5.26
Rate for Payer: Cash Price	$3.61
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$5.26
Rate for Payer: Health Smart Auto/Commercial	$3.94
Rate for Payer: LLUH Dept of Risk Management WC	$3.61
Rate for Payer: Multiplan Commercial	$4.93

MORPHINE ER 100 MG TABLET,EXTENDED RELEASE [20919]

Facility

$6.57

Service Code	NDC 0406-8390-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$5.26
Rate for Payer: Cash Price	$3.61
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$5.26
Rate for Payer: Health Smart Auto/Commercial	$3.94
Rate for Payer: LLUH Dept of Risk Management WC	$3.61
Rate for Payer: Multiplan Commercial	$4.93

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$0.80

Service Code	NDC 0406-8315-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.64
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.48
Rate for Payer: Aetna of CA Government/Medicare	$0.48
Rate for Payer: Cash Price	$0.44
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.64
Rate for Payer: Health Smart Auto/Commercial	$0.48
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.48
Rate for Payer: LLUH Dept of Risk Management WC	$0.44
Rate for Payer: Multiplan Commercial	$0.60

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$1.01

Service Code	NDC 0406-8315-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.81
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.61
Rate for Payer: Aetna of CA Government/Medicare	$0.61
Rate for Payer: Cash Price	$0.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.81
Rate for Payer: Health Smart Auto/Commercial	$0.61
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.61
Rate for Payer: LLUH Dept of Risk Management WC	$0.56
Rate for Payer: Multiplan Commercial	$0.76

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$1.01

Service Code	NDC 0406-8315-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$0.81
Rate for Payer: Cash Price	$0.55
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.81
Rate for Payer: Health Smart Auto/Commercial	$0.61
Rate for Payer: LLUH Dept of Risk Management WC	$0.56
Rate for Payer: Multiplan Commercial	$0.76

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$1.10

Service Code	NDC 0406-8315-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.88
Rate for Payer: Cash Price	$0.60
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.88
Rate for Payer: Health Smart Auto/Commercial	$0.66
Rate for Payer: LLUH Dept of Risk Management WC	$0.61
Rate for Payer: Multiplan Commercial	$0.83

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$0.56

Service Code	NDC 42858-801-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.45
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.34
Rate for Payer: Aetna of CA Government/Medicare	$0.34
Rate for Payer: Cash Price	$0.31
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.45
Rate for Payer: Health Smart Auto/Commercial	$0.34
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.34
Rate for Payer: LLUH Dept of Risk Management WC	$0.31
Rate for Payer: Multiplan Commercial	$0.42

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$1.10

Service Code	NDC 0406-8315-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.88
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.66
Rate for Payer: Aetna of CA Government/Medicare	$0.66
Rate for Payer: Cash Price	$0.60
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.88
Rate for Payer: Health Smart Auto/Commercial	$0.66
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.66
Rate for Payer: LLUH Dept of Risk Management WC	$0.61
Rate for Payer: Multiplan Commercial	$0.83

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$0.56

Service Code	NDC 42858-801-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.45
Rate for Payer: Cash Price	$0.31
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.45
Rate for Payer: Health Smart Auto/Commercial	$0.34
Rate for Payer: LLUH Dept of Risk Management WC	$0.31
Rate for Payer: Multiplan Commercial	$0.42

MORPHINE ER 15 MG TABLET,EXTENDED RELEASE [20920]

Facility

$0.80

Service Code	NDC 0406-8315-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$0.64
Rate for Payer: Cash Price	$0.44
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$0.64
Rate for Payer: Health Smart Auto/Commercial	$0.48
Rate for Payer: LLUH Dept of Risk Management WC	$0.44
Rate for Payer: Multiplan Commercial	$0.60

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.69

Service Code	NDC 68084-158-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.35
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.01
Rate for Payer: Aetna of CA Government/Medicare	$1.01
Rate for Payer: Cash Price	$0.93
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.35
Rate for Payer: Health Smart Auto/Commercial	$1.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.01
Rate for Payer: LLUH Dept of Risk Management WC	$0.93
Rate for Payer: Multiplan Commercial	$1.27

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.69

Service Code	NDC 68084-158-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.35
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.01
Rate for Payer: Aetna of CA Government/Medicare	$1.01
Rate for Payer: Cash Price	$0.93
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.35
Rate for Payer: Health Smart Auto/Commercial	$1.01
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.01
Rate for Payer: LLUH Dept of Risk Management WC	$0.93
Rate for Payer: Multiplan Commercial	$1.27

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$2.08

Service Code	NDC 0406-8330-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.66
Rate for Payer: Cash Price	$1.15
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.66
Rate for Payer: Health Smart Auto/Commercial	$1.25
Rate for Payer: LLUH Dept of Risk Management WC	$1.14
Rate for Payer: Multiplan Commercial	$1.56

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$2.08

Service Code	NDC 0406-8330-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$1.66
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.25
Rate for Payer: Aetna of CA Government/Medicare	$1.25
Rate for Payer: Cash Price	$1.15
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.66
Rate for Payer: Health Smart Auto/Commercial	$1.25
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.25
Rate for Payer: LLUH Dept of Risk Management WC	$1.14
Rate for Payer: Multiplan Commercial	$1.56

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.91

Service Code	NDC 0406-8330-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.53
Rate for Payer: Cash Price	$1.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.53
Rate for Payer: Health Smart Auto/Commercial	$1.15
Rate for Payer: LLUH Dept of Risk Management WC	$1.05
Rate for Payer: Multiplan Commercial	$1.43

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.91

Service Code	NDC 0406-8330-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.53
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.15
Rate for Payer: Aetna of CA Government/Medicare	$1.15
Rate for Payer: Cash Price	$1.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.53
Rate for Payer: Health Smart Auto/Commercial	$1.15
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.15
Rate for Payer: LLUH Dept of Risk Management WC	$1.05
Rate for Payer: Multiplan Commercial	$1.43

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.69

Service Code	NDC 68084-158-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.35
Rate for Payer: Cash Price	$0.93
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.35
Rate for Payer: Health Smart Auto/Commercial	$1.01
Rate for Payer: LLUH Dept of Risk Management WC	$0.93
Rate for Payer: Multiplan Commercial	$1.27

MORPHINE ER 30 MG TABLET,EXTENDED RELEASE [20921]

Facility

$1.69

Service Code	NDC 68084-158-11
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.35
Rate for Payer: Cash Price	$0.93
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$1.35
Rate for Payer: Health Smart Auto/Commercial	$1.01
Rate for Payer: LLUH Dept of Risk Management WC	$0.93
Rate for Payer: Multiplan Commercial	$1.27

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$3.72

Service Code	NDC 0406-8380-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.98
Rate for Payer: Cash Price	$2.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.98
Rate for Payer: Health Smart Auto/Commercial	$2.23
Rate for Payer: LLUH Dept of Risk Management WC	$2.05
Rate for Payer: Multiplan Commercial	$2.79

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$2.98

Service Code	NDC 0406-8380-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.38
Rate for Payer: Cash Price	$1.64
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.38
Rate for Payer: Health Smart Auto/Commercial	$1.79
Rate for Payer: LLUH Dept of Risk Management WC	$1.64
Rate for Payer: Multiplan Commercial	$2.23

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$2.98

Service Code	NDC 0406-8380-01
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$1.79
Rate for Payer: Aetna of CA Government/Medicare	$1.79
Rate for Payer: Cash Price	$1.64
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.38
Rate for Payer: Health Smart Auto/Commercial	$1.79
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$1.79
Rate for Payer: LLUH Dept of Risk Management WC	$1.64
Rate for Payer: Multiplan Commercial	$2.23

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$4.06

Service Code	NDC 0406-8380-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.44
Rate for Payer: Aetna of CA Government/Medicare	$2.44
Rate for Payer: Cash Price	$2.24
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$3.25
Rate for Payer: Health Smart Auto/Commercial	$2.44
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.44
Rate for Payer: LLUH Dept of Risk Management WC	$2.23
Rate for Payer: Multiplan Commercial	$3.04

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$4.06

Service Code	NDC 0406-8380-62
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$3.25
Rate for Payer: Cash Price	$2.24
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$3.25
Rate for Payer: Health Smart Auto/Commercial	$2.44
Rate for Payer: LLUH Dept of Risk Management WC	$2.23
Rate for Payer: Multiplan Commercial	$3.04

MORPHINE ER 60 MG TABLET,EXTENDED RELEASE [20922]

Facility

$3.72

Service Code	NDC 0406-8380-23
Hospital Charge Code	901700029
Hospital Revenue Code	259
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.23
Rate for Payer: Aetna of CA Government/Medicare	$2.23
Rate for Payer: Cash Price	$2.05
Rate for Payer: Evernorth Behavioral Health (Cigna Behavioral Health) - HMO HMO/PPO	$2.98
Rate for Payer: Health Smart Auto/Commercial	$2.23
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.23
Rate for Payer: LLUH Dept of Risk Management WC	$2.05
Rate for Payer: Multiplan Commercial	$2.79

Know your out-of-pocket cost for care.

All Charges