Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RISPERDAL CONST

Facility

$287.00

Hospital Charge Code	60635472
Hospital Revenue Code	636
Min. Negotiated Rate	$43.05
Max. Negotiated Rate	$69.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.05

RISPERDAL CONST

Facility

$287.00

Hospital Charge Code	60635472
Hospital Revenue Code	636
Min. Negotiated Rate	$6.92
Max. Negotiated Rate	$143.50
Rate for Payer: Aetna Commercial	$109.06
Rate for Payer: Aetna Medicare Advantage	$86.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.19
Rate for Payer: Cigna Commercial	$143.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.45
Rate for Payer: Qualcare PPO/HMO/WC	$43.05
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

RISPERDAL CONSTA

Facility

$1,930.00

Hospital Charge Code	60635566
Hospital Revenue Code	636
Min. Negotiated Rate	$289.50
Max. Negotiated Rate	$467.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50

RISPERDAL CONSTA

Facility

$1,930.00

Hospital Charge Code	60635566
Hospital Revenue Code	636
Min. Negotiated Rate	$46.51
Max. Negotiated Rate	$965.00
Rate for Payer: Aetna Commercial	$733.40
Rate for Payer: Aetna Medicare Advantage	$579.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$492.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$492.15
Rate for Payer: Cigna Commercial	$965.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$467.06
Rate for Payer: Qualcare PPO/HMO/WC	$289.50
Rate for Payer: UnitedHealthcare Community & State	$46.51
Rate for Payer: Wellpoint Medicaid Managed Care	$51.15

RISPERDAL CONSTA 12.5MG

Facility

$671.00

Hospital Charge Code	60635696
Hospital Revenue Code	636
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$335.50
Rate for Payer: Aetna Commercial	$254.98
Rate for Payer: Aetna Medicare Advantage	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$171.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$171.10
Rate for Payer: Cigna Commercial	$335.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.38
Rate for Payer: Qualcare PPO/HMO/WC	$100.65
Rate for Payer: UnitedHealthcare Community & State	$16.17
Rate for Payer: Wellpoint Medicaid Managed Care	$17.78

RISPERDAL CONSTA 12.5MG

Facility

$671.00

Hospital Charge Code	60635696
Hospital Revenue Code	636
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$162.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.38
Rate for Payer: Qualcare PPO/HMO/WC	$100.65

RISPERDAL CONSTA 25/2 ML MG SY

Facility

$2,744.72

Service Code	HCPCS J2794
Hospital Charge Code	606350957
Hospital Revenue Code	636
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$664.22
Rate for Payer: Aetna Commercial	$29.38
Rate for Payer: Aetna Medicare Advantage	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Medicare Advantage	$10.80
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.22
Rate for Payer: Qualcare PPO/HMO/WC	$411.71
Rate for Payer: UnitedHealthcare Community & State	$66.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$72.74

RISPERDAL CONSTA 25/2 ML MG SY

Facility

$2,744.72

Service Code	HCPCS J2794
Hospital Charge Code	606350957
Hospital Revenue Code	636
Min. Negotiated Rate	$411.71
Max. Negotiated Rate	$664.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$664.22
Rate for Payer: Qualcare PPO/HMO/WC	$411.71

RISPERDAL CONSTA 50 MG

Facility

$5,489.71

Service Code	HCPCS J2794
Hospital Charge Code	60630117
Hospital Revenue Code	636
Min. Negotiated Rate	$823.46
Max. Negotiated Rate	$1,328.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.51
Rate for Payer: Qualcare PPO/HMO/WC	$823.46

RISPERDAL CONSTA 50 MG

Facility

$5,489.71

Service Code	HCPCS J2794
Hospital Charge Code	60630117
Hospital Revenue Code	636
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$1,328.51
Rate for Payer: Aetna Commercial	$29.38
Rate for Payer: Aetna Medicare Advantage	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Medicare Advantage	$10.80
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,328.51
Rate for Payer: Qualcare PPO/HMO/WC	$823.46
Rate for Payer: UnitedHealthcare Community & State	$132.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$145.48

RISPERDAL TABS 2MG

Facility

$9.00

Hospital Charge Code	60635050
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

RISPERDAL TABS 2MG

Facility

$9.00

Hospital Charge Code	60635050
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

RISPERIDONE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3002320
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

RISPERIDONE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3002320
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

RISPERIDONE 0.25 MG TAB

Facility

$56.62

Service Code	NDC 68084027011
Hospital Charge Code	60628946
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$28.31
Rate for Payer: Aetna Commercial	$21.52
Rate for Payer: Aetna Medicare Advantage	$16.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.44
Rate for Payer: Cigna Commercial	$28.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.99
Rate for Payer: Oxford Commercial	$11.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Commercial	$11.32
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.50

RISPERIDONE 0.25 MG TAB

Facility

$56.62

Service Code	NDC 68084027011
Hospital Charge Code	60628946
Hospital Revenue Code	250
Min. Negotiated Rate	$8.49
Max. Negotiated Rate	$8.49
Rate for Payer: Qualcare PPO/HMO/WC	$8.49

RISPERIDONE 0.5MG ODT TAB

Facility

$64.92

Service Code	NDC 50458039528
Hospital Charge Code	6063943171
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$32.46
Rate for Payer: Aetna Commercial	$24.67
Rate for Payer: Aetna Medicare Advantage	$19.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.55
Rate for Payer: Cigna Commercial	$32.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.48
Rate for Payer: Oxford Commercial	$12.98
Rate for Payer: Qualcare PPO/HMO/WC	$9.74
Rate for Payer: UnitedHealthcare Commercial	$12.98
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

RISPERIDONE 0.5MG ODT TAB

Facility

$64.92

Service Code	NDC 50458039528
Hospital Charge Code	6063943171
Hospital Revenue Code	250
Min. Negotiated Rate	$9.74
Max. Negotiated Rate	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.74

RISPERIDONE 0.5 MG TAB

Facility

$62.18

Service Code	NDC 50458030201
Hospital Charge Code	60629305
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$31.09
Rate for Payer: Aetna Commercial	$23.63
Rate for Payer: Aetna Medicare Advantage	$18.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.86
Rate for Payer: Cigna Commercial	$31.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.65
Rate for Payer: Oxford Commercial	$12.44
Rate for Payer: Qualcare PPO/HMO/WC	$9.33
Rate for Payer: UnitedHealthcare Commercial	$12.44
Rate for Payer: UnitedHealthcare Community & State	$1.50
Rate for Payer: Wellpoint Medicaid Managed Care	$1.65

RISPERIDONE 0.5 MG TAB

Facility

$62.18

Service Code	NDC 50458030201
Hospital Charge Code	60629305
Hospital Revenue Code	250
Min. Negotiated Rate	$9.33
Max. Negotiated Rate	$9.33
Rate for Payer: Qualcare PPO/HMO/WC	$9.33

RISPERIDONE 1 MG/ML ORAL SOLN

Facility

$73.83

Service Code	NDC 50458030503
Hospital Charge Code	60629037
Hospital Revenue Code	250
Min. Negotiated Rate	$11.07
Max. Negotiated Rate	$11.07
Rate for Payer: Qualcare PPO/HMO/WC	$11.07

RISPERIDONE 1 MG/ML ORAL SOLN

Facility

$73.83

Service Code	NDC 50458030503
Hospital Charge Code	60629037
Hospital Revenue Code	250
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$36.91
Rate for Payer: Aetna Commercial	$28.06
Rate for Payer: Aetna Medicare Advantage	$22.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.83
Rate for Payer: Cigna Commercial	$36.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.15
Rate for Payer: Oxford Commercial	$14.77
Rate for Payer: Qualcare PPO/HMO/WC	$11.07
Rate for Payer: UnitedHealthcare Commercial	$14.77
Rate for Payer: UnitedHealthcare Community & State	$1.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.96

RISPERIDONE 1MG ODT TAB

Facility

$75.84

Service Code	NDC 50458031528
Hospital Charge Code	6063943172
Hospital Revenue Code	250
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$11.38
Rate for Payer: Qualcare PPO/HMO/WC	$11.38

RISPERIDONE 1MG ODT TAB

Facility

$75.84

Service Code	NDC 50458031528
Hospital Charge Code	6063943172
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$37.92
Rate for Payer: Aetna Commercial	$28.82
Rate for Payer: Aetna Medicare Advantage	$22.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.34
Rate for Payer: Cigna Commercial	$37.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.75
Rate for Payer: Oxford Commercial	$15.17
Rate for Payer: Qualcare PPO/HMO/WC	$11.38
Rate for Payer: UnitedHealthcare Commercial	$15.17
Rate for Payer: UnitedHealthcare Community & State	$1.83
Rate for Payer: Wellpoint Medicaid Managed Care	$2.01

RISPERIDONE 1 MG TAB

Facility

$66.06

Service Code	NDC 50458030001
Hospital Charge Code	6017651
Hospital Revenue Code	250
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.03
Rate for Payer: Aetna Commercial	$25.10
Rate for Payer: Aetna Medicare Advantage	$19.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.85
Rate for Payer: Cigna Commercial	$33.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.82
Rate for Payer: Oxford Commercial	$13.21
Rate for Payer: Qualcare PPO/HMO/WC	$9.91
Rate for Payer: UnitedHealthcare Commercial	$13.21
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

Know your out-of-pocket cost for care.

All Charges