Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

RISPERIDONE 1 MG/ML ORAL SOLUTION [17377]

Facility

OP

$0.84

Service Code	NDC 65162-673-84
Hospital Charge Code	1715198
Hospital Revenue Code	259
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.63
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.50
Rate for Payer: Aetna of CA Government/Medicare	$0.50
Rate for Payer: Cash Price	$0.38
Rate for Payer: Health Smart Auto/Commercial	$0.50
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.50
Rate for Payer: LLUH Dept of Risk Management WC	$0.46
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.63

RISPERIDONE 1 MG/ML ORAL SOLUTION [17377]

Facility

OP

$4.87

Service Code	NDC 50458-596-01
Hospital Charge Code	1715198
Hospital Revenue Code	259
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$3.65
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.92
Rate for Payer: Aetna of CA Government/Medicare	$2.92
Rate for Payer: Cash Price	$2.19
Rate for Payer: Health Smart Auto/Commercial	$2.92
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.92
Rate for Payer: LLUH Dept of Risk Management WC	$2.68
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.65

RISPERIDONE 1 MG/ML ORAL SOLUTION [17377]

Facility

OP

$1.20

Service Code	NDC 0054-0063-44
Hospital Charge Code	1715198
Hospital Revenue Code	259
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$0.90
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.72
Rate for Payer: Aetna of CA Government/Medicare	$0.72
Rate for Payer: Cash Price	$0.54
Rate for Payer: Health Smart Auto/Commercial	$0.72
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.72
Rate for Payer: LLUH Dept of Risk Management WC	$0.66
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.90

RISPERIDONE 1 MG/ML ORAL SOLUTION [17377]

Facility

IP

$4.87

Service Code	NDC 50458-596-01
Hospital Charge Code	1715198
Hospital Revenue Code	259
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$3.90
Rate for Payer: Cash Price	$2.19
Rate for Payer: Cigna of CA HMO/PPO	$3.90
Rate for Payer: Health Smart Auto/Commercial	$2.92
Rate for Payer: LLUH Dept of Risk Management WC	$2.68
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.65

RISPERIDONE 1 MG TABLET [18313]

Facility

IP

$0.50

Service Code	NDC 68084-272-01
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.40
Rate for Payer: Cash Price	$0.23
Rate for Payer: Cigna of CA HMO/PPO	$0.40
Rate for Payer: Health Smart Auto/Commercial	$0.30
Rate for Payer: LLUH Dept of Risk Management WC	$0.28
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.38

RISPERIDONE 1 MG TABLET [18313]

Facility

OP

$0.50

Service Code	NDC 68084-272-11
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.38
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.30
Rate for Payer: Aetna of CA Government/Medicare	$0.30
Rate for Payer: Cash Price	$0.23
Rate for Payer: Health Smart Auto/Commercial	$0.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.30
Rate for Payer: LLUH Dept of Risk Management WC	$0.28
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.38

RISPERIDONE 1 MG TABLET [18313]

Facility

OP

$0.50

Service Code	NDC 68084-272-01
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.38
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.30
Rate for Payer: Aetna of CA Government/Medicare	$0.30
Rate for Payer: Cash Price	$0.23
Rate for Payer: Health Smart Auto/Commercial	$0.30
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.30
Rate for Payer: LLUH Dept of Risk Management WC	$0.28
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.38

RISPERIDONE 1 MG TABLET [18313]

Facility

IP

$0.21

Service Code	NDC 0904-6359-61
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.17
Rate for Payer: Cash Price	$0.09
Rate for Payer: Cigna of CA HMO/PPO	$0.17
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.16

RISPERIDONE 1 MG TABLET [18313]

Facility

IP

$0.24

Service Code	NDC 43547-341-06
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.19
Rate for Payer: Cash Price	$0.11
Rate for Payer: Cigna of CA HMO/PPO	$0.19
Rate for Payer: Health Smart Auto/Commercial	$0.14
Rate for Payer: LLUH Dept of Risk Management WC	$0.13
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.18

RISPERIDONE 1 MG TABLET [18313]

Facility

IP

$0.16

Service Code	NDC 68382-114-14
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.13
Rate for Payer: Cash Price	$0.07
Rate for Payer: Cigna of CA HMO/PPO	$0.13
Rate for Payer: Health Smart Auto/Commercial	$0.10
Rate for Payer: LLUH Dept of Risk Management WC	$0.09
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.12

RISPERIDONE 1 MG TABLET [18313]

Facility

OP

$0.21

Service Code	NDC 0904-6359-61
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.16
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.13
Rate for Payer: Aetna of CA Government/Medicare	$0.13
Rate for Payer: Cash Price	$0.09
Rate for Payer: Health Smart Auto/Commercial	$0.13
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.13
Rate for Payer: LLUH Dept of Risk Management WC	$0.12
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.16

RISPERIDONE 1 MG TABLET [18313]

Facility

OP

$0.24

Service Code	NDC 43547-341-06
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.18
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.14
Rate for Payer: Aetna of CA Government/Medicare	$0.14
Rate for Payer: Cash Price	$0.11
Rate for Payer: Health Smart Auto/Commercial	$0.14
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.14
Rate for Payer: LLUH Dept of Risk Management WC	$0.13
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.18

RISPERIDONE 1 MG TABLET [18313]

Facility

IP

$0.50

Service Code	NDC 68084-272-11
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.40
Rate for Payer: Cash Price	$0.23
Rate for Payer: Cigna of CA HMO/PPO	$0.40
Rate for Payer: Health Smart Auto/Commercial	$0.30
Rate for Payer: LLUH Dept of Risk Management WC	$0.28
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.38

RISPERIDONE 1 MG TABLET [18313]

Facility

OP

$0.16

Service Code	NDC 68382-114-14
Hospital Charge Code	1712178
Hospital Revenue Code	259
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.12
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$0.10
Rate for Payer: Aetna of CA Government/Medicare	$0.10
Rate for Payer: Cash Price	$0.07
Rate for Payer: Health Smart Auto/Commercial	$0.10
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$0.10
Rate for Payer: LLUH Dept of Risk Management WC	$0.09
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.12

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

OP

$7.36

Service Code	NDC 0781-5312-06
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$5.52
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.42
Rate for Payer: Aetna of CA Government/Medicare	$4.42
Rate for Payer: Cash Price	$3.31
Rate for Payer: Health Smart Auto/Commercial	$4.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.42
Rate for Payer: LLUH Dept of Risk Management WC	$4.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.52

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

OP

$7.97

Service Code	NDC 49884-401-91
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$5.98
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.78
Rate for Payer: Aetna of CA Government/Medicare	$4.78
Rate for Payer: Cash Price	$3.59
Rate for Payer: Health Smart Auto/Commercial	$4.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.78
Rate for Payer: LLUH Dept of Risk Management WC	$4.38
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.98

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

IP

$7.36

Service Code	NDC 0781-5312-08
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$5.89
Rate for Payer: Cash Price	$3.31
Rate for Payer: Cigna of CA HMO/PPO	$5.89
Rate for Payer: Health Smart Auto/Commercial	$4.42
Rate for Payer: LLUH Dept of Risk Management WC	$4.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.52

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

IP

$4.01

Service Code	NDC 59746-030-22
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$3.21
Rate for Payer: Cash Price	$1.80
Rate for Payer: Cigna of CA HMO/PPO	$3.21
Rate for Payer: Health Smart Auto/Commercial	$2.41
Rate for Payer: LLUH Dept of Risk Management WC	$2.21
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.01

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

OP

$7.36

Service Code	NDC 0781-5312-08
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$5.52
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.42
Rate for Payer: Aetna of CA Government/Medicare	$4.42
Rate for Payer: Cash Price	$3.31
Rate for Payer: Health Smart Auto/Commercial	$4.42
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.42
Rate for Payer: LLUH Dept of Risk Management WC	$4.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.52

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

IP

$7.97

Service Code	NDC 49884-401-52
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$6.38
Rate for Payer: Cash Price	$3.59
Rate for Payer: Cigna of CA HMO/PPO	$6.38
Rate for Payer: Health Smart Auto/Commercial	$4.78
Rate for Payer: LLUH Dept of Risk Management WC	$4.38
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.98

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

OP

$4.01

Service Code	NDC 59746-030-22
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$3.01
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$2.41
Rate for Payer: Aetna of CA Government/Medicare	$2.41
Rate for Payer: Cash Price	$1.80
Rate for Payer: Health Smart Auto/Commercial	$2.41
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$2.41
Rate for Payer: LLUH Dept of Risk Management WC	$2.21
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$3.01

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

OP

$7.97

Service Code	NDC 49884-401-52
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$5.98
Rate for Payer: Aetna of CA EPO/HMO/POS/PPO	$4.78
Rate for Payer: Aetna of CA Government/Medicare	$4.78
Rate for Payer: Cash Price	$3.59
Rate for Payer: Health Smart Auto/Commercial	$4.78
Rate for Payer: Kaiser Permanente of CA Medi-Cal/Medicare Advantage	$4.78
Rate for Payer: LLUH Dept of Risk Management WC	$4.38
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.98

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

IP

$7.97

Service Code	NDC 49884-401-91
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$6.38
Rate for Payer: Cash Price	$3.59
Rate for Payer: Cigna of CA HMO/PPO	$6.38
Rate for Payer: Health Smart Auto/Commercial	$4.78
Rate for Payer: LLUH Dept of Risk Management WC	$4.38
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.98

RISPERIDONE 2 MG DISINTEGRATING TABLET [35688]

Facility

IP

$7.36

Service Code	NDC 0781-5312-06
Hospital Charge Code	1713153
Hospital Revenue Code	259
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$5.89
Rate for Payer: Cash Price	$3.31
Rate for Payer: Cigna of CA HMO/PPO	$5.89
Rate for Payer: Health Smart Auto/Commercial	$4.42
Rate for Payer: LLUH Dept of Risk Management WC	$4.05
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$5.52

RISPERIDONE 2 MG TABLET [18311]

Facility

IP

$0.23

Service Code	NDC 0904-6360-61
Hospital Charge Code	1712188
Hospital Revenue Code	259
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$0.18
Rate for Payer: Cash Price	$0.10
Rate for Payer: Cigna of CA HMO/PPO	$0.18
Rate for Payer: Health Smart Auto/Commercial	$0.14
Rate for Payer: LLUH Dept of Risk Management WC	$0.13
Rate for Payer: Multiplan Beech St/Commercial/PHCS	$0.17

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