MORPHINE 10 MG/ML INJ
|
Facility
|
OP
|
$0.77
|
|
Hospital Charge Code |
41653707
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.27 |
Max. Negotiated Rate |
$0.62 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.42
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.39
|
Rate for Payer: Aetna Government |
$0.39
|
Rate for Payer: Brighton Health Commercial |
$0.58
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.62
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.52
|
Rate for Payer: Group Health Inc Commercial |
$0.39
|
Rate for Payer: Group Health Inc Medicare |
$0.27
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.39
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.39
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.50
|
|
MORPHINE 10 MG/ML INJ
|
Facility
|
OP
|
$0.77
|
|
Hospital Charge Code |
41643707
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.27 |
Max. Negotiated Rate |
$0.50 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.42
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.39
|
Rate for Payer: Aetna Government |
$0.39
|
Rate for Payer: Brighton Health Commercial |
$0.46
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.39
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.44
|
Rate for Payer: Group Health Inc Commercial |
$0.39
|
Rate for Payer: Group Health Inc Medicare |
$0.27
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.39
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.39
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.50
|
|
MORPHINE 10 MG/ML INJ
|
Facility
|
IP
|
$0.77
|
|
Hospital Charge Code |
41643707
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.39 |
Max. Negotiated Rate |
$0.39 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.39
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.39
|
|
MORPHINE 15 MG TAB
|
Facility
|
OP
|
$0.52
|
|
Hospital Charge Code |
41652892
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.18 |
Max. Negotiated Rate |
$0.42 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.29
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.26
|
Rate for Payer: Aetna Government |
$0.26
|
Rate for Payer: Brighton Health Commercial |
$0.39
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.42
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.35
|
Rate for Payer: Group Health Inc Commercial |
$0.26
|
Rate for Payer: Group Health Inc Medicare |
$0.18
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.26
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.26
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.34
|
|
MORPHINE 15 MG TAB
|
Facility
|
OP
|
$0.52
|
|
Hospital Charge Code |
41642892
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.18 |
Max. Negotiated Rate |
$0.42 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.29
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.26
|
Rate for Payer: Aetna Government |
$0.26
|
Rate for Payer: Brighton Health Commercial |
$0.39
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.42
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.35
|
Rate for Payer: Group Health Inc Commercial |
$0.26
|
Rate for Payer: Group Health Inc Medicare |
$0.18
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.26
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.26
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.34
|
|
MORPHINE 15 MG TAB CR
|
Facility
|
OP
|
$0.31
|
|
Hospital Charge Code |
41654300
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.25 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.17
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.16
|
Rate for Payer: Aetna Government |
$0.16
|
Rate for Payer: Brighton Health Commercial |
$0.23
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.25
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.21
|
Rate for Payer: Group Health Inc Commercial |
$0.16
|
Rate for Payer: Group Health Inc Medicare |
$0.11
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.16
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.20
|
|
MORPHINE 15 MG TAB CR
|
Facility
|
OP
|
$0.31
|
|
Hospital Charge Code |
41644300
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.25 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.17
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.16
|
Rate for Payer: Aetna Government |
$0.16
|
Rate for Payer: Brighton Health Commercial |
$0.23
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.25
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.21
|
Rate for Payer: Group Health Inc Commercial |
$0.16
|
Rate for Payer: Group Health Inc Medicare |
$0.11
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.16
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.20
|
|
MORPHINE 20MG/ML 30ML CONCENTRATE
|
Facility
|
OP
|
$16.42
|
|
Hospital Charge Code |
41658420
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$5.75 |
Max. Negotiated Rate |
$13.14 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.03
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.21
|
Rate for Payer: Aetna Government |
$8.21
|
Rate for Payer: Brighton Health Commercial |
$12.32
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.14
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.17
|
Rate for Payer: Group Health Inc Commercial |
$8.21
|
Rate for Payer: Group Health Inc Medicare |
$5.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.21
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$8.21
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.67
|
|
MORPHINE 20MG/ML 30ML CONCENTRATE
|
Facility
|
OP
|
$16.42
|
|
Hospital Charge Code |
41648420
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$5.75 |
Max. Negotiated Rate |
$13.14 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.03
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.21
|
Rate for Payer: Aetna Government |
$8.21
|
Rate for Payer: Brighton Health Commercial |
$12.32
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.14
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.17
|
Rate for Payer: Group Health Inc Commercial |
$8.21
|
Rate for Payer: Group Health Inc Medicare |
$5.75
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.21
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$8.21
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.67
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
OP
|
$11.78
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41644696
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$3.39 |
Max. Negotiated Rate |
$7.66 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.48
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$7.07
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.89
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.77
|
Rate for Payer: Group Health Inc Commercial |
$5.89
|
Rate for Payer: Group Health Inc Medicare |
$4.12
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.89
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.89
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.66
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
OP
|
$11.78
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41654696
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$3.39 |
Max. Negotiated Rate |
$7.66 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.48
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$7.07
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.89
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.77
|
Rate for Payer: Group Health Inc Commercial |
$5.89
|
Rate for Payer: Group Health Inc Medicare |
$4.12
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.89
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.89
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.66
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
IP
|
$11.78
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41654696
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$5.89 |
Max. Negotiated Rate |
$5.89 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.89
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.89
|
|
MORPHINE 2 MG/ML INJ
|
Facility
|
IP
|
$11.78
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41644696
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$5.89 |
Max. Negotiated Rate |
$5.89 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.89
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$5.89
|
|
MORPHINE 30 MG TAB
|
Facility
|
OP
|
$0.88
|
|
Hospital Charge Code |
41642893
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.31 |
Max. Negotiated Rate |
$0.70 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.48
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
Rate for Payer: Aetna Government |
$0.44
|
Rate for Payer: Brighton Health Commercial |
$0.66
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.70
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
Rate for Payer: Group Health Inc Commercial |
$0.44
|
Rate for Payer: Group Health Inc Medicare |
$0.31
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
MORPHINE 30 MG TAB
|
Facility
|
OP
|
$0.88
|
|
Hospital Charge Code |
41652893
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.31 |
Max. Negotiated Rate |
$0.70 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.48
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
Rate for Payer: Aetna Government |
$0.44
|
Rate for Payer: Brighton Health Commercial |
$0.66
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.70
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
Rate for Payer: Group Health Inc Commercial |
$0.44
|
Rate for Payer: Group Health Inc Medicare |
$0.31
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
MORPHINE 30 MG TAB CR
|
Facility
|
OP
|
$0.93
|
|
Hospital Charge Code |
41654288
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.33 |
Max. Negotiated Rate |
$0.74 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.51
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.47
|
Rate for Payer: Aetna Government |
$0.47
|
Rate for Payer: Brighton Health Commercial |
$0.70
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.74
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.63
|
Rate for Payer: Group Health Inc Commercial |
$0.47
|
Rate for Payer: Group Health Inc Medicare |
$0.33
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.47
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.47
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.60
|
|
MORPHINE 30 MG TAB CR
|
Facility
|
OP
|
$0.93
|
|
Hospital Charge Code |
41644288
|
Hospital Revenue Code
|
250
|
Min. Negotiated Rate |
$0.33 |
Max. Negotiated Rate |
$0.74 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.51
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.47
|
Rate for Payer: Aetna Government |
$0.47
|
Rate for Payer: Brighton Health Commercial |
$0.70
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.74
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.63
|
Rate for Payer: Group Health Inc Commercial |
$0.47
|
Rate for Payer: Group Health Inc Medicare |
$0.33
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.47
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$0.47
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.60
|
|
MORPHINE 4MG/1ML VIAL
|
Facility
|
OP
|
$2.33
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41657815
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.82 |
Max. Negotiated Rate |
$4.72 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.28
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$1.40
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.16
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.34
|
Rate for Payer: Group Health Inc Commercial |
$1.16
|
Rate for Payer: Group Health Inc Medicare |
$0.82
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.16
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.51
|
|
MORPHINE 4MG/1ML VIAL
|
Facility
|
IP
|
$2.33
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41647815
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.16 |
Max. Negotiated Rate |
$1.16 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.16
|
|
MORPHINE 4MG/1ML VIAL
|
Facility
|
IP
|
$2.33
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41657815
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.16 |
Max. Negotiated Rate |
$1.16 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.16
|
|
MORPHINE 4MG/1ML VIAL
|
Facility
|
OP
|
$2.33
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41647815
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.82 |
Max. Negotiated Rate |
$4.72 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.28
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$1.40
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.16
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.34
|
Rate for Payer: Group Health Inc Commercial |
$1.16
|
Rate for Payer: Group Health Inc Medicare |
$0.82
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.16
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.16
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.51
|
|
MORPHINE 4 MG/ML INJ
|
Facility
|
OP
|
$3.00
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41642408
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.05 |
Max. Negotiated Rate |
$4.72 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$1.80
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.72
|
Rate for Payer: Group Health Inc Commercial |
$1.50
|
Rate for Payer: Group Health Inc Medicare |
$1.05
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
MORPHINE 4 MG/ML INJ
|
Facility
|
IP
|
$3.00
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41652408
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.50 |
Max. Negotiated Rate |
$1.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
|
MORPHINE 4 MG/ML INJ
|
Facility
|
OP
|
$3.00
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41652408
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.05 |
Max. Negotiated Rate |
$4.72 |
Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1.65
|
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.39
|
Rate for Payer: Aetna Government |
$3.39
|
Rate for Payer: Brighton Health Commercial |
$1.80
|
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.50
|
Rate for Payer: Cigna LocalPlus Benefit Plan |
$1.72
|
Rate for Payer: Group Health Inc Commercial |
$1.50
|
Rate for Payer: Group Health Inc Medicare |
$1.05
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4.72
|
Rate for Payer: SOMOS Essential |
$4.72
|
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1.95
|
|
MORPHINE 4 MG/ML INJ
|
Facility
|
IP
|
$3.00
|
|
Service Code
|
HCPCS J2270
|
Hospital Charge Code |
41642408
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$1.50 |
Max. Negotiated Rate |
$1.50 |
Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.50
|
Rate for Payer: Hamaspik Choice Inc Medicare |
$1.50
|
|