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Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

HALOPERIDOL 5 MG PO TABS

Facility

OP

$1.02

Service Code	NDC 6838207910
Hospital Charge Code	6838207910
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.51
Rate for Payer: Aetna Government	$0.51
Rate for Payer: Brighton Health Commercial	$0.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.70
Rate for Payer: EmblemHealth Commercial	$0.51
Rate for Payer: Group Health Inc Commercial	$0.51
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51
Rate for Payer: Hamaspik Choice Inc Medicare	$0.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.67

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$36.00

Service Code	HCPCS J1631
Hospital Charge Code	7075661610
Hospital Revenue Code	250
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$48.50

Service Code	HCPCS J1631
Hospital Charge Code	7006938301
Hospital Revenue Code	250
Min. Negotiated Rate	$24.25
Max. Negotiated Rate	$24.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.25

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$48.50

Service Code	HCPCS J1631
Hospital Charge Code	7006938301
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$38.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$36.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.98
Rate for Payer: EmblemHealth Commercial	$24.25
Rate for Payer: Group Health Inc Commercial	$24.25
Rate for Payer: Group Health Inc Medicare	$16.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.25
Rate for Payer: Hamaspik Choice Inc Medicare	$24.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.52

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$32.40

Service Code	HCPCS J1631
Hospital Charge Code	7075661681
Hospital Revenue Code	250
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.20

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$48.00

Service Code	HCPCS J1631
Hospital Charge Code	2502183301
Hospital Revenue Code	250
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.00

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$52.32

Service Code	HCPCS J1631
Hospital Charge Code	2502183405
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$41.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$39.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.58
Rate for Payer: EmblemHealth Commercial	$26.16
Rate for Payer: Group Health Inc Commercial	$26.16
Rate for Payer: Group Health Inc Medicare	$18.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.16
Rate for Payer: Hamaspik Choice Inc Medicare	$26.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.01

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$52.32

Service Code	HCPCS J1631
Hospital Charge Code	2502183405
Hospital Revenue Code	250
Min. Negotiated Rate	$26.16
Max. Negotiated Rate	$26.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.16

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$48.00

Service Code	HCPCS J1631
Hospital Charge Code	2502183301
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$38.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$36.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.64
Rate for Payer: EmblemHealth Commercial	$24.00
Rate for Payer: Group Health Inc Commercial	$24.00
Rate for Payer: Group Health Inc Medicare	$16.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.00
Rate for Payer: Hamaspik Choice Inc Medicare	$24.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.20

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$52.80

Service Code	HCPCS J1631
Hospital Charge Code	7071014631
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$42.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$39.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.90
Rate for Payer: EmblemHealth Commercial	$26.40
Rate for Payer: Group Health Inc Commercial	$26.40
Rate for Payer: Group Health Inc Medicare	$18.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.40
Rate for Payer: Hamaspik Choice Inc Medicare	$26.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.32

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$52.80

Service Code	HCPCS J1631
Hospital Charge Code	6745740913
Hospital Revenue Code	250
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.40

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$36.00

Service Code	HCPCS J1631
Hospital Charge Code	7075661610
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$28.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$27.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.48
Rate for Payer: EmblemHealth Commercial	$18.00
Rate for Payer: Group Health Inc Commercial	$18.00
Rate for Payer: Group Health Inc Medicare	$12.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.40

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$61.78

Service Code	HCPCS J1631
Hospital Charge Code	6332347101
Hospital Revenue Code	250
Min. Negotiated Rate	$30.89
Max. Negotiated Rate	$30.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.89

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$52.80

Service Code	HCPCS J1631
Hospital Charge Code	6745740913
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$42.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$39.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.90
Rate for Payer: EmblemHealth Commercial	$26.40
Rate for Payer: Group Health Inc Commercial	$26.40
Rate for Payer: Group Health Inc Medicare	$18.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.40
Rate for Payer: Hamaspik Choice Inc Medicare	$26.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.32

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$32.40

Service Code	HCPCS J1631
Hospital Charge Code	7075661681
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$25.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$24.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.03
Rate for Payer: EmblemHealth Commercial	$16.20
Rate for Payer: Group Health Inc Commercial	$16.20
Rate for Payer: Group Health Inc Medicare	$11.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.20
Rate for Payer: Hamaspik Choice Inc Medicare	$16.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.06

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$52.44

Service Code	HCPCS J1631
Hospital Charge Code	0703713103
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$41.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$39.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.66
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Group Health Inc Commercial	$26.22
Rate for Payer: Group Health Inc Medicare	$18.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.22
Rate for Payer: Hamaspik Choice Inc Medicare	$26.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.09

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$52.44

Service Code	HCPCS J1631
Hospital Charge Code	0703713103
Hospital Revenue Code	250
Min. Negotiated Rate	$26.22
Max. Negotiated Rate	$26.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.22

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$52.80

Service Code	HCPCS J1631
Hospital Charge Code	7071014631
Hospital Revenue Code	250
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.40

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$36.00

Service Code	HCPCS J1631
Hospital Charge Code	7128850301
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$28.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$27.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.48
Rate for Payer: EmblemHealth Commercial	$18.00
Rate for Payer: Group Health Inc Commercial	$18.00
Rate for Payer: Group Health Inc Medicare	$12.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.40

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$36.00

Service Code	HCPCS J1631
Hospital Charge Code	7128850301
Hospital Revenue Code	250
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$44.23

Service Code	HCPCS J1631
Hospital Charge Code	0143929601
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$35.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$33.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.08
Rate for Payer: EmblemHealth Commercial	$22.12
Rate for Payer: Group Health Inc Commercial	$22.12
Rate for Payer: Group Health Inc Medicare	$15.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.12
Rate for Payer: Hamaspik Choice Inc Medicare	$22.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.75

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

IP

$44.23

Service Code	HCPCS J1631
Hospital Charge Code	0143929601
Hospital Revenue Code	250
Min. Negotiated Rate	$22.12
Max. Negotiated Rate	$22.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.12

HALOPERIDOL DECANOATE 100 MG/ML IM SOLN

Facility

OP

$61.78

Service Code	HCPCS J1631
Hospital Charge Code	6332347101
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$49.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$46.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.01
Rate for Payer: EmblemHealth Commercial	$30.89
Rate for Payer: Group Health Inc Commercial	$30.89
Rate for Payer: Group Health Inc Medicare	$21.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.89
Rate for Payer: Hamaspik Choice Inc Medicare	$30.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$40.16

HALOPERIDOL DECANOATE 50 MG/ML IM SOLN

Facility

OP

$26.68

Service Code	HCPCS J1631
Hospital Charge Code	7006938110
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$21.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$20.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.14
Rate for Payer: EmblemHealth Commercial	$13.34
Rate for Payer: Group Health Inc Commercial	$13.34
Rate for Payer: Group Health Inc Medicare	$9.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.34
Rate for Payer: Hamaspik Choice Inc Medicare	$13.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.34

HALOPERIDOL DECANOATE 50 MG/ML IM SOLN

Facility

OP

$31.07

Service Code	HCPCS J1631
Hospital Charge Code	1014709213
Hospital Revenue Code	250
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$24.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.57
Rate for Payer: Aetna Government	$9.57
Rate for Payer: Brighton Health Commercial	$23.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.13
Rate for Payer: EmblemHealth Commercial	$15.53
Rate for Payer: Group Health Inc Commercial	$15.53
Rate for Payer: Group Health Inc Medicare	$10.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.53
Rate for Payer: Hamaspik Choice Inc Medicare	$15.53
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.19

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