St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HALF PIN FIX 5MM DIA 150MM A

Facility

$390.00

Hospital Charge Code	64905342
Hospital Revenue Code	270
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$312.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.00
Rate for Payer: Aetna Government	$195.00
Rate for Payer: Brighton Health Commercial	$292.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.20
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

HALF PIN FIX 5MM DIA 150MM B

Facility

$390.00

Hospital Charge Code	64905908
Hospital Revenue Code	270
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$312.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.00
Rate for Payer: Aetna Government	$195.00
Rate for Payer: Brighton Health Commercial	$292.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.20
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

HALF PIN FIX 6MM DIA 150MMA

Facility

$414.38

Hospital Charge Code	64905261
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 150MMB

Facility

$414.38

Hospital Charge Code	64905763
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 150MMD

Facility

$414.38

Hospital Charge Code	64905998
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 180MM

Facility

$414.38

Hospital Charge Code	64905223
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 200MMA

Facility

$414.38

Hospital Charge Code	64904896
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 200MMB

Facility

$414.38

Hospital Charge Code	64905344
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 200MMC

Facility

$414.38

Hospital Charge Code	64905996
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

HALF PIN FIX 6MM DIA 200MMD

Facility

$414.38

Hospital Charge Code	64905997
Hospital Revenue Code	270
Min. Negotiated Rate	$145.03
Max. Negotiated Rate	$331.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.19
Rate for Payer: Aetna Government	$207.19
Rate for Payer: Brighton Health Commercial	$310.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.78
Rate for Payer: Group Health Inc Commercial	$207.19
Rate for Payer: Group Health Inc Medicare	$145.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.19
Rate for Payer: Hamaspik Choice Inc Medicare	$207.19

Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant

Facility

$3,818.01

Service Code	CPT 28289
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$3,818.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Affinity Essential Plan 1&2	$2,620.20
Rate for Payer: Affinity Essential Plan 3&4	$2,620.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,620.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Humana Medicare	$3,818.01
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

HALLUX VULGUS OSTEOTOMY

Facility

$8,291.05

Service Code	HCPCS 28296
Hospital Charge Code	40029959
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Affinity Essential Plan 1&2	$2,620.20
Rate for Payer: Affinity Essential Plan 3&4	$2,620.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,620.20
Rate for Payer: Brighton Health Commercial	$6,218.29
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Humana Medicare	$3,818.01
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

HALLUX VULGUS OSTEOTOMY

Facility

$8,291.05

Service Code	HCPCS 28296
Hospital Charge Code	40029959
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

HALOPERIDOL 0.5 MG PO TABS [3578]

Facility

$0.35

Service Code	NDC 51079073320
Hospital Charge Code	51079073320
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.17
Rate for Payer: Aetna Government	$0.17
Rate for Payer: Brighton Health Commercial	$0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

HALOPERIDOL 0.5 MG PO TABS [3578]

Facility

$0.35

Service Code	NDC 51079073301
Hospital Charge Code	51079073301
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$0.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.17
Rate for Payer: Aetna Government	$0.17
Rate for Payer: Brighton Health Commercial	$0.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.24
Rate for Payer: Group Health Inc Commercial	$0.17
Rate for Payer: Group Health Inc Medicare	$0.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.17
Rate for Payer: Hamaspik Choice Inc Medicare	$0.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.23

HALOPERIDOL 0.5 MG PO TABS [3578]

Facility

$0.47

Service Code	NDC 00904724061
Hospital Charge Code	00904724061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.32
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.30

HALOPERIDOL 0.5 MG PO TABS [3578]

Facility

$0.33

Service Code	NDC 00378035101
Hospital Charge Code	00378035101
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.21

HALOPERIDOL 0.5 MG TAB

Facility

$1.00

Hospital Charge Code	41650302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

HALOPERIDOL 0.5 MG TAB

Facility

$1.00

Hospital Charge Code	41640302
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

HALOPERIDOL 10 MG TAB

Facility

$3.00

Hospital Charge Code	41650784
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

HALOPERIDOL 10 MG TAB

Facility

$3.00

Hospital Charge Code	41640784
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

HALOPERIDOL 1 MG PO TABS [3579]

Facility

$0.66

Service Code	NDC 00904724161
Hospital Charge Code	00904724161
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.33
Rate for Payer: Aetna Government	$0.33
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.45
Rate for Payer: Group Health Inc Commercial	$0.33
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.33
Rate for Payer: Hamaspik Choice Inc Medicare	$0.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.43

HALOPERIDOL 1 MG PO TABS [3579]

Facility

$0.49

Service Code	NDC 51079073420
Hospital Charge Code	51079073420
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.33
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

HALOPERIDOL 1 MG TAB

Facility

$0.08

Hospital Charge Code	41643491
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

HALOPERIDOL 1 MG TAB

Facility

$0.08

Hospital Charge Code	41653491
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

Know your out-of-pocket cost for care.

All Charges