Hoboken 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 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	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
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	$39.18
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	$173.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$155.91

RISPERIDONE 0.25 MG TAB

Facility

$56.62

Service Code	NDC 68084027011
Hospital Charge Code	60628946
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
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	$14.72
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	$1.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1.61

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	$1.84
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	$16.88
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	$2.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.84

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 0.5 MG TAB

Facility

$62.18

Service Code	NDC 50458030201
Hospital Charge Code	60629305
Hospital Revenue Code	250
Min. Negotiated Rate	$1.77
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	$16.17
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	$1.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.77

RISPERIDONE 1 MG/ML ORAL SOLN

Facility

$73.83

Service Code	NDC 50458030503
Hospital Charge Code	60629037
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
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	$19.20
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	$2.33
Rate for Payer: Wellpoint Medicaid Managed Care	$2.10

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 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	$2.15
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	$19.72
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	$2.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.15

RISPERIDONE 1 MG TAB

Facility

$66.06

Service Code	NDC 50458030001
Hospital Charge Code	6017651
Hospital Revenue Code	250
Min. Negotiated Rate	$1.88
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	$17.18
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	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

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	$3.50
Max. Negotiated Rate	$61.67
Rate for Payer: Aetna Commercial	$46.87
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	$32.07
Rate for Payer: Oxford Commercial	$24.67
Rate for Payer: Qualcare PPO/HMO/WC	$18.50
Rate for Payer: UnitedHealthcare Commercial	$24.67
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$3.50

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	$3.14
Max. Negotiated Rate	$55.21
Rate for Payer: Aetna Commercial	$41.96
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	$28.71
Rate for Payer: Oxford Commercial	$22.08
Rate for Payer: Qualcare PPO/HMO/WC	$16.56
Rate for Payer: UnitedHealthcare Commercial	$22.08
Rate for Payer: UnitedHealthcare Community & State	$3.49
Rate for Payer: Wellpoint Medicaid Managed Care	$3.14

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	$3.68
Max. Negotiated Rate	$64.86
Rate for Payer: Aetna Commercial	$49.29
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	$33.72
Rate for Payer: Oxford Commercial	$25.94
Rate for Payer: Qualcare PPO/HMO/WC	$19.46
Rate for Payer: UnitedHealthcare Commercial	$25.94
Rate for Payer: UnitedHealthcare Community & State	$4.10
Rate for Payer: Wellpoint Medicaid Managed Care	$3.68

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 CONSTA 12.5MG/2ML

Facility

$1,372.50

Service Code	HCPCS J2794
Hospital Charge Code	606390334
Hospital Revenue Code	636
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$332.14
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	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
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	$39.18
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	$332.14
Rate for Payer: Qualcare PPO/HMO/WC	$205.88
Rate for Payer: UnitedHealthcare Community & State	$43.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$38.98

RISPERIDONE CONSTA 12.5MG/2ML

Facility

$1,372.50

Service Code	HCPCS J2794
Hospital Charge Code	606390334
Hospital Revenue Code	636
Min. Negotiated Rate	$205.88
Max. Negotiated Rate	$332.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.14
Rate for Payer: Qualcare PPO/HMO/WC	$205.88

RISPERIDONE CONSTA 12.5MG INJ

Facility

$5,259.00

Hospital Charge Code	6063943174
Hospital Revenue Code	636
Min. Negotiated Rate	$149.36
Max. Negotiated Rate	$2,629.50
Rate for Payer: Aetna Commercial	$1,998.42
Rate for Payer: Aetna Medicare Advantage	$1,577.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,341.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,341.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,341.05
Rate for Payer: Cigna Commercial	$2,629.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.68
Rate for Payer: Qualcare PPO/HMO/WC	$788.85
Rate for Payer: UnitedHealthcare Community & State	$166.18
Rate for Payer: Wellpoint Medicaid Managed Care	$149.36

RISPERIDONE CONSTA 12.5MG INJ

Facility

$5,259.00

Hospital Charge Code	6063943174
Hospital Revenue Code	636
Min. Negotiated Rate	$788.85
Max. Negotiated Rate	$1,272.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,272.68
Rate for Payer: Qualcare PPO/HMO/WC	$788.85

RISPERIDONE CONSTA 37.5MG/2 ML

Facility

$4,117.22

Service Code	HCPCS J2794
Hospital Charge Code	60630030
Hospital Revenue Code	636
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$996.37
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	$39.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.18
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	$39.18
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	$996.37
Rate for Payer: Qualcare PPO/HMO/WC	$617.58
Rate for Payer: UnitedHealthcare Community & State	$130.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$116.93

Know your out-of-pocket cost for care.

All Charges