Heights University Hospital

All Charges

Charge

Type

Setting

Price

HALOPERIDOL 0.5 MG TAB

Facility

$4.00

Service Code	NDC 781139113
Hospital Charge Code	60627800
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HALOPERIDOL/0.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633076
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HALOPERIDOL/0.5MG/TAB

Facility

$3.00

Hospital Charge Code	60633076
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HALOPERIDOL 100 MG/ML INJ

Facility

$1,214.38

Service Code	HCPCS J1631
Hospital Charge Code	6011035
Hospital Revenue Code	636
Min. Negotiated Rate	$182.16
Max. Negotiated Rate	$293.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.88
Rate for Payer: Qualcare PPO/HMO/WC	$182.16

HALOPERIDOL 100 MG/ML INJ

Facility

$1,214.38

Service Code	HCPCS J1631
Hospital Charge Code	6011035
Hospital Revenue Code	636
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$364.31
Rate for Payer: Aetna Commercial	$364.31
Rate for Payer: Aetna Medicare Advantage	$364.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$309.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$309.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$309.67
Rate for Payer: Cigna Commercial	$6.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$293.88
Rate for Payer: Qualcare PPO/HMO/WC	$182.16

HALOPERIDOL 10 MG TAB

Facility

$11.99

Service Code	NDC 781139713
Hospital Charge Code	60627801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$3.60
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.56
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$6.00

HALOPERIDOL 10 MG TAB

Facility

$11.99

Service Code	NDC 781139713
Hospital Charge Code	60627801
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

HALOPERIDOL 1 MG TAB

Facility

$4.00

Service Code	NDC 781139213
Hospital Charge Code	60627802
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HALOPERIDOL 1 MG TAB

Facility

$4.00

Service Code	NDC 781139213
Hospital Charge Code	60627802
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

HALOPERIDOL 2 MG TAB

Facility

$4.02

Service Code	NDC 781139313
Hospital Charge Code	60627803
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HALOPERIDOL 2 MG TAB

Facility

$4.02

Service Code	NDC 781139313
Hospital Charge Code	60627803
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.21
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$2.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$2.01

HALOPERIDOL 5 MG/ML INJ

Facility

$8.84

Service Code	HCPCS J1630
Hospital Charge Code	60627805
Hospital Revenue Code	636
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$2.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

HALOPERIDOL 5 MG/ML INJ

Facility

$8.84

Service Code	HCPCS J1630
Hospital Charge Code	60627805
Hospital Revenue Code	636
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$2.65
Rate for Payer: Aetna Commercial	$2.65
Rate for Payer: Aetna Medicare Advantage	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$0.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

HALOPERIDOL 5 MG TAB

Facility

$6.50

Service Code	NDC 781139613
Hospital Charge Code	6022529
Hospital Revenue Code	251
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

HALOPERIDOL 5 MG TAB

Facility

$6.50

Service Code	NDC 781139613
Hospital Charge Code	6022529
Hospital Revenue Code	251
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$1.95
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.85
Rate for Payer: Oxford Commercial	$3.25
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$3.25

HALOPERIDOL/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633077
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HALOPERIDOL/5MG/TAB

Facility

$3.00

Hospital Charge Code	60633077
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HALOPERIDOL CONC LQ 2MG/ML

Facility

$4.00

Hospital Charge Code	60627806
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

HALOPERIDOL CONC LQ 2MG/ML

Facility

$4.00

Hospital Charge Code	60627806
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

HALOPERIDOL DECAN 50MG/ML

Facility

$163.20

Hospital Charge Code	6011019
Hospital Revenue Code	250
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$81.60
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$48.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$81.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.22
Rate for Payer: Oxford Commercial	$81.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.48
Rate for Payer: UnitedHealthcare Commercial	$81.60

HALOPERIDOL DECAN 50MG/ML

Facility

$163.20

Hospital Charge Code	6011019
Hospital Revenue Code	250
Min. Negotiated Rate	$24.48
Max. Negotiated Rate	$24.48
Rate for Payer: Qualcare PPO/HMO/WC	$24.48

HALOPERIDOL DECAN INJ 50MG/ML

Facility

$192.96

Service Code	HCPCS J1631
Hospital Charge Code	60627804
Hospital Revenue Code	636
Min. Negotiated Rate	$28.94
Max. Negotiated Rate	$46.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

HALOPERIDOL DECAN INJ 50MG/ML

Facility

$192.96

Service Code	HCPCS J1631
Hospital Charge Code	60627804
Hospital Revenue Code	636
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$57.89
Rate for Payer: Aetna Commercial	$57.89
Rate for Payer: Aetna Medicare Advantage	$57.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.20
Rate for Payer: Cigna Commercial	$6.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.70
Rate for Payer: Qualcare PPO/HMO/WC	$28.94

HALOPERIDOL (HALDOL)

Facility

$324.00

Service Code	HCPCS 80173
Hospital Charge Code	38473128
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

HALOPERIDOL (HALDOL)

Facility

$324.00

Service Code	HCPCS 80173
Hospital Charge Code	38473128
Hospital Revenue Code	301
Min. Negotiated Rate	$7.89
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$51.13
Rate for Payer: Aetna Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.82
Rate for Payer: Cigna Commercial	$15.78
Rate for Payer: Cigna Medicare Advantage	$7.89
Rate for Payer: Clover Medicare Advantage	$14.99
Rate for Payer: EmblemHealth Commercial	$47.34
Rate for Payer: Humana Medicare Advantage	$16.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.78
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$16.73
Rate for Payer: Wellcare Medicare Advantage	$15.78

Know your out-of-pocket cost for care.

All Charges