Heights University Hospital

All Charges

Charge

Type

Setting

Price

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 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	$1.17
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$2.70
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	$1.17
Rate for Payer: Oxford Commercial	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$4.50

RISPERIDONE

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3002320
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
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	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
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: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

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	$7.36
Max. Negotiated Rate	$28.31
Rate for Payer: Aetna Commercial	$16.99
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	$7.36
Rate for Payer: Oxford Commercial	$28.31
Rate for Payer: Qualcare PPO/HMO/WC	$8.49
Rate for Payer: UnitedHealthcare Commercial	$28.31

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	$9.74
Max. Negotiated Rate	$9.74
Rate for Payer: Qualcare PPO/HMO/WC	$9.74

RISPERIDONE 0.5MG ODT TAB

Facility

$64.92

Service Code	NDC 50458039528
Hospital Charge Code	6063943171
Hospital Revenue Code	250
Min. Negotiated Rate	$8.44
Max. Negotiated Rate	$32.46
Rate for Payer: Aetna Commercial	$19.48
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	$8.44
Rate for Payer: Oxford Commercial	$32.46
Rate for Payer: Qualcare PPO/HMO/WC	$9.74
Rate for Payer: UnitedHealthcare Commercial	$32.46

RISPERIDONE 0.5 MG TAB

Facility

$62.18

Service Code	NDC 50458030201
Hospital Charge Code	60629305
Hospital Revenue Code	250
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$31.09
Rate for Payer: Aetna Commercial	$18.65
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	$8.08
Rate for Payer: Oxford Commercial	$31.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.33
Rate for Payer: UnitedHealthcare Commercial	$31.09

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	$9.60
Max. Negotiated Rate	$36.91
Rate for Payer: Aetna Commercial	$22.15
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	$9.60
Rate for Payer: Oxford Commercial	$36.91
Rate for Payer: Qualcare PPO/HMO/WC	$11.07
Rate for Payer: UnitedHealthcare Commercial	$36.91

RISPERIDONE 1MG ODT TAB

Facility

$75.84

Service Code	NDC 50458031528
Hospital Charge Code	6063943172
Hospital Revenue Code	250
Min. Negotiated Rate	$9.86
Max. Negotiated Rate	$37.92
Rate for Payer: Aetna Commercial	$22.75
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	$9.86
Rate for Payer: Oxford Commercial	$37.92
Rate for Payer: Qualcare PPO/HMO/WC	$11.38
Rate for Payer: UnitedHealthcare Commercial	$37.92

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 1 MG TAB

Facility

$66.06

Service Code	NDC 50458030001
Hospital Charge Code	6017651
Hospital Revenue Code	250
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$33.03
Rate for Payer: Aetna Commercial	$19.82
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	$8.59
Rate for Payer: Oxford Commercial	$33.03
Rate for Payer: Qualcare PPO/HMO/WC	$9.91
Rate for Payer: UnitedHealthcare Commercial	$33.03

RISPERIDONE 1 MG TAB

Facility

$66.06

Service Code	NDC 50458030001
Hospital Charge Code	6017651
Hospital Revenue Code	250
Min. Negotiated Rate	$9.91
Max. Negotiated Rate	$9.91
Rate for Payer: Qualcare PPO/HMO/WC	$9.91

RISPERIDONE 2MG ODT TAB

Facility

$123.35

Service Code	NDC 50458032528
Hospital Charge Code	6063943173
Hospital Revenue Code	250
Min. Negotiated Rate	$16.04
Max. Negotiated Rate	$61.67
Rate for Payer: Aetna Commercial	$37.01
Rate for Payer: Aetna Medicare Advantage	$37.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.45
Rate for Payer: Cigna Commercial	$61.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.04
Rate for Payer: Oxford Commercial	$61.67
Rate for Payer: Qualcare PPO/HMO/WC	$18.50
Rate for Payer: UnitedHealthcare Commercial	$61.67

RISPERIDONE 2MG ODT TAB

Facility

$123.35

Service Code	NDC 50458032528
Hospital Charge Code	6063943173
Hospital Revenue Code	250
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$18.50
Rate for Payer: Qualcare PPO/HMO/WC	$18.50

RISPERIDONE 2 MG TAB

Facility

$110.42

Service Code	NDC 50458032001
Hospital Charge Code	6017644
Hospital Revenue Code	250
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$55.21
Rate for Payer: Aetna Commercial	$33.13
Rate for Payer: Aetna Medicare Advantage	$33.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.16
Rate for Payer: Cigna Commercial	$55.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.35
Rate for Payer: Oxford Commercial	$55.21
Rate for Payer: Qualcare PPO/HMO/WC	$16.56
Rate for Payer: UnitedHealthcare Commercial	$55.21

RISPERIDONE 2 MG TAB

Facility

$110.42

Service Code	NDC 50458032001
Hospital Charge Code	6017644
Hospital Revenue Code	250
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$16.56
Rate for Payer: Qualcare PPO/HMO/WC	$16.56

RISPERIDONE 3 MG TAB

Facility

$129.71

Service Code	NDC 50458033001
Hospital Charge Code	60627817
Hospital Revenue Code	250
Min. Negotiated Rate	$19.46
Max. Negotiated Rate	$19.46
Rate for Payer: Qualcare PPO/HMO/WC	$19.46

RISPERIDONE 3 MG TAB

Facility

$129.71

Service Code	NDC 50458033001
Hospital Charge Code	60627817
Hospital Revenue Code	250
Min. Negotiated Rate	$16.86
Max. Negotiated Rate	$64.86
Rate for Payer: Aetna Commercial	$38.91
Rate for Payer: Aetna Medicare Advantage	$38.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.08
Rate for Payer: Cigna Commercial	$64.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.86
Rate for Payer: Oxford Commercial	$64.86
Rate for Payer: Qualcare PPO/HMO/WC	$19.46
Rate for Payer: UnitedHealthcare Commercial	$64.86

RISPERIDONE & 9-OH-RISPER

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035111
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
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	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
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: MagnaCare PPO/Direct Plus/Exchange/WC	$23.61
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

RISPERIDONE & 9-OH-RISPER

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3035111
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

Know your out-of-pocket cost for care.

All Charges