Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

CHLORPROMAZINE HCL 25 MG/ML IJ SOLN

Facility

IP

$34.67

Service Code	HCPCS J3230
Hospital Charge Code	5515031825
Hospital Revenue Code	250
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$17.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.33

CHLORPROMAZINE HCL 25 MG/ML IJ SOLN

Facility

IP

$20.93

Service Code	HCPCS J3230
Hospital Charge Code	6521912800
Hospital Revenue Code	250
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$10.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.46

CHLORPROMAZINE HCL 25 MG/ML IJ SOLN

Facility

OP

$29.95

Service Code	HCPCS J3230
Hospital Charge Code	4359814011
Hospital Revenue Code	250
Min. Negotiated Rate	$10.48
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$22.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.37
Rate for Payer: EmblemHealth Commercial	$14.98
Rate for Payer: Group Health Inc Commercial	$14.98
Rate for Payer: Group Health Inc Medicare	$10.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.98
Rate for Payer: Hamaspik Choice Inc Medicare	$14.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$19.47

CHLORPROMAZINE HCL 25 MG/ML IJ SOLN

Facility

IP

$34.67

Service Code	HCPCS J3230
Hospital Charge Code	5515031801
Hospital Revenue Code	250
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$17.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.33

CHLORPROMAZINE HCL 25 MG/ML IJ SOLN

Facility

IP

$34.67

Service Code	HCPCS J3230
Hospital Charge Code	0641139735
Hospital Revenue Code	250
Min. Negotiated Rate	$17.33
Max. Negotiated Rate	$17.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.33

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

OP

$6.25

Service Code	NDC 0904713061
Hospital Charge Code	0904713061
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$5.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.12
Rate for Payer: Aetna Government	$3.12
Rate for Payer: Brighton Health Commercial	$4.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.25
Rate for Payer: EmblemHealth Commercial	$3.12
Rate for Payer: Group Health Inc Commercial	$3.12
Rate for Payer: Group Health Inc Medicare	$2.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.06

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

IP

$6.25

Service Code	NDC 0904713061
Hospital Charge Code	0904713061
Hospital Revenue Code	250
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$3.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.12

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

IP

$7.64

Service Code	NDC 7071011301
Hospital Charge Code	7071011301
Hospital Revenue Code	250
Min. Negotiated Rate	$3.82
Max. Negotiated Rate	$3.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.82

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

IP

$11.08

Service Code	NDC 0832030101
Hospital Charge Code	0832030101
Hospital Revenue Code	250
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$5.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.54

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

IP

$7.49

Service Code	NDC 5026816315
Hospital Charge Code	5026816315
Hospital Revenue Code	250
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$3.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.74

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

OP

$7.49

Service Code	NDC 5026816311
Hospital Charge Code	5026816311
Hospital Revenue Code	250
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$5.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.74
Rate for Payer: Aetna Government	$3.74
Rate for Payer: Brighton Health Commercial	$5.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.09
Rate for Payer: EmblemHealth Commercial	$3.74
Rate for Payer: Group Health Inc Commercial	$3.74
Rate for Payer: Group Health Inc Medicare	$2.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.74
Rate for Payer: Hamaspik Choice Inc Medicare	$3.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.87

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

IP

$7.49

Service Code	NDC 5026816311
Hospital Charge Code	5026816311
Hospital Revenue Code	250
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$3.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.74

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

OP

$7.49

Service Code	NDC 5026816315
Hospital Charge Code	5026816315
Hospital Revenue Code	250
Min. Negotiated Rate	$2.62
Max. Negotiated Rate	$5.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.74
Rate for Payer: Aetna Government	$3.74
Rate for Payer: Brighton Health Commercial	$5.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.09
Rate for Payer: EmblemHealth Commercial	$3.74
Rate for Payer: Group Health Inc Commercial	$3.74
Rate for Payer: Group Health Inc Medicare	$2.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.74
Rate for Payer: Hamaspik Choice Inc Medicare	$3.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.87

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

OP

$7.64

Service Code	NDC 7071011301
Hospital Charge Code	7071011301
Hospital Revenue Code	250
Min. Negotiated Rate	$2.67
Max. Negotiated Rate	$6.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.82
Rate for Payer: Aetna Government	$3.82
Rate for Payer: Brighton Health Commercial	$5.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.20
Rate for Payer: EmblemHealth Commercial	$3.82
Rate for Payer: Group Health Inc Commercial	$3.82
Rate for Payer: Group Health Inc Medicare	$2.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.82
Rate for Payer: Hamaspik Choice Inc Medicare	$3.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.97

CHLORPROMAZINE HCL 25 MG PO TABS

Facility

OP

$11.08

Service Code	NDC 0832030101
Hospital Charge Code	0832030101
Hospital Revenue Code	250
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$8.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.54
Rate for Payer: Aetna Government	$5.54
Rate for Payer: Brighton Health Commercial	$8.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.53
Rate for Payer: EmblemHealth Commercial	$5.54
Rate for Payer: Group Health Inc Commercial	$5.54
Rate for Payer: Group Health Inc Medicare	$3.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.54
Rate for Payer: Hamaspik Choice Inc Medicare	$5.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.20

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

IP

$19.86

Service Code	HCPCS J3230
Hospital Charge Code	5515031901
Hospital Revenue Code	250
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$9.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.93

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$17.16

Service Code	HCPCS J3230
Hospital Charge Code	4359814111
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$12.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.67
Rate for Payer: EmblemHealth Commercial	$8.58
Rate for Payer: Group Health Inc Commercial	$8.58
Rate for Payer: Group Health Inc Medicare	$6.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.58
Rate for Payer: Hamaspik Choice Inc Medicare	$8.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.15

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

IP

$17.16

Service Code	HCPCS J3230
Hospital Charge Code	7071018507
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$8.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.58

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$19.86

Service Code	HCPCS J3230
Hospital Charge Code	0641139835
Hospital Revenue Code	250
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$14.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.51
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$9.93
Rate for Payer: Group Health Inc Medicare	$6.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.93
Rate for Payer: Hamaspik Choice Inc Medicare	$9.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.91

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$19.86

Service Code	HCPCS J3230
Hospital Charge Code	5515031925
Hospital Revenue Code	250
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$14.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.50
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$9.93
Rate for Payer: Group Health Inc Medicare	$6.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.93
Rate for Payer: Hamaspik Choice Inc Medicare	$9.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.91

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

IP

$17.16

Service Code	HCPCS J3230
Hospital Charge Code	4359814111
Hospital Revenue Code	250
Min. Negotiated Rate	$8.58
Max. Negotiated Rate	$8.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.58

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$12.60

Service Code	HCPCS J3230
Hospital Charge Code	6679425002
Hospital Revenue Code	250
Min. Negotiated Rate	$4.41
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$9.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.57
Rate for Payer: EmblemHealth Commercial	$6.30
Rate for Payer: Group Health Inc Commercial	$6.30
Rate for Payer: Group Health Inc Medicare	$4.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.30
Rate for Payer: Hamaspik Choice Inc Medicare	$6.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.19

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$19.86

Service Code	HCPCS J3230
Hospital Charge Code	5515031901
Hospital Revenue Code	250
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$14.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.50
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$9.93
Rate for Payer: Group Health Inc Medicare	$6.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.93
Rate for Payer: Hamaspik Choice Inc Medicare	$9.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.91

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

IP

$19.86

Service Code	HCPCS J3230
Hospital Charge Code	0641139835
Hospital Revenue Code	250
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$9.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.93

CHLORPROMAZINE HCL 50 MG/2ML IJ SOLN

Facility

OP

$17.16

Service Code	HCPCS J3230
Hospital Charge Code	7071018507
Hospital Revenue Code	250
Min. Negotiated Rate	$6.01
Max. Negotiated Rate	$32.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.87
Rate for Payer: Aetna Government	$32.87
Rate for Payer: Brighton Health Commercial	$12.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.67
Rate for Payer: EmblemHealth Commercial	$8.58
Rate for Payer: Group Health Inc Commercial	$8.58
Rate for Payer: Group Health Inc Medicare	$6.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.58
Rate for Payer: Hamaspik Choice Inc Medicare	$8.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.15

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