St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 2061: Malfunction,reaction,complication of cardiac/vasc device or procedure

Facility IP

$39,312.70

Service Code	APR-DRG 2061
Min. Negotiated Rate	$6,645.00
Max. Negotiated Rate	$39,312.70
Rate for Payer: Amida Care Medicaid	$17,472.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,472.31
Rate for Payer: Fidelis Qualified Health Plan	$20,966.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,472.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,472.31
Rate for Payer: Healthfirst Commercial	$10,119.00
Rate for Payer: Healthfirst Essential Plan	$39,312.70
Rate for Payer: Healthfirst QHP	$6,645.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,472.31
Rate for Payer: SOMOS Essential	$39,312.70
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,472.31

APR-DRG 2062: Malfunction,reaction,complication of cardiac/vasc device or procedure

Facility IP

$42,441.52

Service Code	APR-DRG 2062
Min. Negotiated Rate	$8,271.00
Max. Negotiated Rate	$42,441.52
Rate for Payer: Amida Care Medicaid	$18,862.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,862.90
Rate for Payer: Fidelis Qualified Health Plan	$22,635.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,862.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,862.90
Rate for Payer: Healthfirst Commercial	$13,727.00
Rate for Payer: Healthfirst Essential Plan	$42,441.52
Rate for Payer: Healthfirst QHP	$8,271.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,862.90
Rate for Payer: SOMOS Essential	$42,441.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,862.90

APR-DRG 2063: Malfunction,reaction,complication of cardiac/vasc device or procedure

Facility IP

$51,525.45

Service Code	APR-DRG 2063
Min. Negotiated Rate	$13,535.00
Max. Negotiated Rate	$51,525.45
Rate for Payer: Amida Care Medicaid	$22,900.20
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,900.20
Rate for Payer: Fidelis Qualified Health Plan	$27,480.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,900.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,900.20
Rate for Payer: Healthfirst Commercial	$22,856.00
Rate for Payer: Healthfirst Essential Plan	$51,525.45
Rate for Payer: Healthfirst QHP	$13,535.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,900.20
Rate for Payer: SOMOS Essential	$51,525.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,900.20

APR-DRG 2064: Malfunction,reaction,complication of cardiac/vasc device or procedure

Facility IP

$89,519.62

Service Code	APR-DRG 2064
Min. Negotiated Rate	$28,294.00
Max. Negotiated Rate	$89,519.62
Rate for Payer: Amida Care Medicaid	$39,786.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,786.50
Rate for Payer: Fidelis Qualified Health Plan	$47,743.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,786.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,786.50
Rate for Payer: Healthfirst Commercial	$50,746.00
Rate for Payer: Healthfirst Essential Plan	$89,519.62
Rate for Payer: Healthfirst QHP	$28,294.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,786.50
Rate for Payer: SOMOS Essential	$89,519.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,786.50

APR-DRG 2071: Other circulatory system diagnoses

Facility IP

$38,241.63

Service Code	APR-DRG 2071
Min. Negotiated Rate	$5,853.00
Max. Negotiated Rate	$38,241.63
Rate for Payer: Amida Care Medicaid	$16,996.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,996.28
Rate for Payer: Fidelis Qualified Health Plan	$20,395.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,996.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,996.28
Rate for Payer: Healthfirst Commercial	$10,123.00
Rate for Payer: Healthfirst Essential Plan	$38,241.63
Rate for Payer: Healthfirst QHP	$5,853.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,996.28
Rate for Payer: SOMOS Essential	$38,241.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,996.28

APR-DRG 2072: Other circulatory system diagnoses

Facility IP

$42,255.09

Service Code	APR-DRG 2072
Min. Negotiated Rate	$7,882.00
Max. Negotiated Rate	$42,255.09
Rate for Payer: Amida Care Medicaid	$18,780.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,780.04
Rate for Payer: Fidelis Qualified Health Plan	$22,536.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,780.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,780.04
Rate for Payer: Healthfirst Commercial	$13,675.00
Rate for Payer: Healthfirst Essential Plan	$42,255.09
Rate for Payer: Healthfirst QHP	$7,882.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,780.04
Rate for Payer: SOMOS Essential	$42,255.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,780.04

APR-DRG 2073: Other circulatory system diagnoses

Facility IP

$50,799.08

Service Code	APR-DRG 2073
Min. Negotiated Rate	$11,470.00
Max. Negotiated Rate	$50,799.08
Rate for Payer: Amida Care Medicaid	$22,577.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,577.37
Rate for Payer: Fidelis Qualified Health Plan	$27,092.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,577.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,577.37
Rate for Payer: Healthfirst Commercial	$21,338.00
Rate for Payer: Healthfirst Essential Plan	$50,799.08
Rate for Payer: Healthfirst QHP	$11,470.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,577.37
Rate for Payer: SOMOS Essential	$50,799.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,577.37

APR-DRG 2074: Other circulatory system diagnoses

Facility IP

$74,086.63

Service Code	APR-DRG 2074
Min. Negotiated Rate	$20,117.00
Max. Negotiated Rate	$74,086.63
Rate for Payer: Amida Care Medicaid	$32,927.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,927.39
Rate for Payer: Fidelis Qualified Health Plan	$39,512.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,927.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,927.39
Rate for Payer: Healthfirst Commercial	$44,832.00
Rate for Payer: Healthfirst Essential Plan	$74,086.63
Rate for Payer: Healthfirst QHP	$20,117.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,927.39
Rate for Payer: SOMOS Essential	$74,086.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,927.39

APR-DRG 2201: Major stomach, esophageal & duodenal procedures

Facility IP

$50,019.95

Service Code	APR-DRG 2201
Min. Negotiated Rate	$14,682.00
Max. Negotiated Rate	$50,019.95
Rate for Payer: Amida Care Medicaid	$22,231.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,231.09
Rate for Payer: Fidelis Qualified Health Plan	$26,677.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,231.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,231.09
Rate for Payer: Healthfirst Commercial	$23,772.00
Rate for Payer: Healthfirst Essential Plan	$50,019.95
Rate for Payer: Healthfirst QHP	$14,682.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,231.09
Rate for Payer: SOMOS Essential	$50,019.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,231.09

APR-DRG 2202: Major stomach, esophageal & duodenal procedures

Facility IP

$62,095.50

Service Code	APR-DRG 2202
Min. Negotiated Rate	$22,319.00
Max. Negotiated Rate	$62,095.50
Rate for Payer: Amida Care Medicaid	$27,598.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,598.00
Rate for Payer: Fidelis Qualified Health Plan	$33,117.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,598.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,598.00
Rate for Payer: Healthfirst Commercial	$36,320.00
Rate for Payer: Healthfirst Essential Plan	$62,095.50
Rate for Payer: Healthfirst QHP	$22,319.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,598.00
Rate for Payer: SOMOS Essential	$62,095.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,598.00

APR-DRG 2203: Major stomach, esophageal & duodenal procedures

Facility IP

$89,489.74

Service Code	APR-DRG 2203
Min. Negotiated Rate	$39,773.22
Max. Negotiated Rate	$89,489.74
Rate for Payer: Amida Care Medicaid	$39,773.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,773.22
Rate for Payer: Fidelis Qualified Health Plan	$47,727.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,773.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,773.22
Rate for Payer: Healthfirst Commercial	$62,671.00
Rate for Payer: Healthfirst Essential Plan	$89,489.74
Rate for Payer: Healthfirst QHP	$39,790.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,773.22
Rate for Payer: SOMOS Essential	$89,489.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,773.22

APR-DRG 2204: Major stomach, esophageal & duodenal procedures

Facility IP

$154,297.78

Service Code	APR-DRG 2204
Min. Negotiated Rate	$68,576.79
Max. Negotiated Rate	$154,297.78
Rate for Payer: Amida Care Medicaid	$68,576.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$68,576.79
Rate for Payer: Fidelis Qualified Health Plan	$82,292.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$68,576.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$68,576.79
Rate for Payer: Healthfirst Commercial	$132,555.00
Rate for Payer: Healthfirst Essential Plan	$154,297.78
Rate for Payer: Healthfirst QHP	$79,821.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$68,576.79
Rate for Payer: SOMOS Essential	$154,297.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$68,576.79

APR-DRG 2211: Major small & large bowel procedures

Facility IP

$55,788.64

Service Code	APR-DRG 2211
Min. Negotiated Rate	$16,712.00
Max. Negotiated Rate	$55,788.64
Rate for Payer: Amida Care Medicaid	$24,794.95
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,794.95
Rate for Payer: Fidelis Qualified Health Plan	$29,753.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,794.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,794.95
Rate for Payer: Healthfirst Commercial	$27,590.00
Rate for Payer: Healthfirst Essential Plan	$55,788.64
Rate for Payer: Healthfirst QHP	$16,712.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,794.95
Rate for Payer: SOMOS Essential	$55,788.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,794.95

APR-DRG 2212: Major small & large bowel procedures

Facility IP

$62,755.04

Service Code	APR-DRG 2212
Min. Negotiated Rate	$21,173.00
Max. Negotiated Rate	$62,755.04
Rate for Payer: Amida Care Medicaid	$27,891.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,891.13
Rate for Payer: Fidelis Qualified Health Plan	$33,469.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,891.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,891.13
Rate for Payer: Healthfirst Commercial	$35,123.00
Rate for Payer: Healthfirst Essential Plan	$62,755.04
Rate for Payer: Healthfirst QHP	$21,173.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,891.13
Rate for Payer: SOMOS Essential	$62,755.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,891.13

APR-DRG 2213: Major small & large bowel procedures

Facility IP

$84,188.88

Service Code	APR-DRG 2213
Min. Negotiated Rate	$34,086.00
Max. Negotiated Rate	$84,188.88
Rate for Payer: Amida Care Medicaid	$37,417.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,417.28
Rate for Payer: Fidelis Qualified Health Plan	$44,900.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,417.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,417.28
Rate for Payer: Healthfirst Commercial	$58,175.00
Rate for Payer: Healthfirst Essential Plan	$84,188.88
Rate for Payer: Healthfirst QHP	$34,086.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,417.28
Rate for Payer: SOMOS Essential	$84,188.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,417.28

APR-DRG 2214: Major small & large bowel procedures

Facility IP

$145,866.35

Service Code	APR-DRG 2214
Min. Negotiated Rate	$64,829.49
Max. Negotiated Rate	$145,866.35
Rate for Payer: Amida Care Medicaid	$64,829.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$64,829.49
Rate for Payer: Fidelis Qualified Health Plan	$77,795.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$64,829.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$64,829.49
Rate for Payer: Healthfirst Commercial	$115,187.00
Rate for Payer: Healthfirst Essential Plan	$145,866.35
Rate for Payer: Healthfirst QHP	$69,553.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$64,829.49
Rate for Payer: SOMOS Essential	$145,866.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$64,829.49

APR-DRG 2221: Other stomach, esophageal & duodenal procedures

Facility IP

$44,115.84

Service Code	APR-DRG 2221
Min. Negotiated Rate	$10,256.00
Max. Negotiated Rate	$44,115.84
Rate for Payer: Amida Care Medicaid	$19,607.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,607.04
Rate for Payer: Fidelis Qualified Health Plan	$23,528.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,607.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,607.04
Rate for Payer: Healthfirst Commercial	$17,248.00
Rate for Payer: Healthfirst Essential Plan	$44,115.84
Rate for Payer: Healthfirst QHP	$10,256.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,607.04
Rate for Payer: SOMOS Essential	$44,115.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,607.04

APR-DRG 2222: Other stomach, esophageal & duodenal procedures

Facility IP

$49,585.54

Service Code	APR-DRG 2222
Min. Negotiated Rate	$13,513.00
Max. Negotiated Rate	$49,585.54
Rate for Payer: Amida Care Medicaid	$22,038.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,038.02
Rate for Payer: Fidelis Qualified Health Plan	$26,445.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,038.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,038.02
Rate for Payer: Healthfirst Commercial	$22,137.00
Rate for Payer: Healthfirst Essential Plan	$49,585.54
Rate for Payer: Healthfirst QHP	$13,513.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,038.02
Rate for Payer: SOMOS Essential	$49,585.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,038.02

APR-DRG 2223: Other stomach, esophageal & duodenal procedures

Facility IP

$65,656.96

Service Code	APR-DRG 2223
Min. Negotiated Rate	$27,581.00
Max. Negotiated Rate	$65,656.96
Rate for Payer: Amida Care Medicaid	$29,180.87
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,180.87
Rate for Payer: Fidelis Qualified Health Plan	$35,017.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,180.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,180.87
Rate for Payer: Healthfirst Commercial	$44,742.00
Rate for Payer: Healthfirst Essential Plan	$65,656.96
Rate for Payer: Healthfirst QHP	$27,581.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,180.87
Rate for Payer: SOMOS Essential	$65,656.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,180.87

APR-DRG 2224: Other stomach, esophageal & duodenal procedures

Facility IP

$126,972.14

Service Code	APR-DRG 2224
Min. Negotiated Rate	$56,432.06
Max. Negotiated Rate	$126,972.14
Rate for Payer: Amida Care Medicaid	$56,432.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$56,432.06
Rate for Payer: Fidelis Qualified Health Plan	$67,718.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$56,432.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$56,432.06
Rate for Payer: Healthfirst Commercial	$88,879.00
Rate for Payer: Healthfirst Essential Plan	$126,972.14
Rate for Payer: Healthfirst QHP	$68,392.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56,432.06
Rate for Payer: SOMOS Essential	$126,972.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56,432.06

APR-DRG 2231: Other small & large bowel procedures

Facility IP

$50,341.82

Service Code	APR-DRG 2231
Min. Negotiated Rate	$13,708.00
Max. Negotiated Rate	$50,341.82
Rate for Payer: Amida Care Medicaid	$22,374.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,374.14
Rate for Payer: Fidelis Qualified Health Plan	$26,848.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,374.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,374.14
Rate for Payer: Healthfirst Commercial	$22,691.00
Rate for Payer: Healthfirst Essential Plan	$50,341.82
Rate for Payer: Healthfirst QHP	$13,708.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,374.14
Rate for Payer: SOMOS Essential	$50,341.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,374.14

APR-DRG 2232: Other small & large bowel procedures

Facility IP

$57,336.34

Service Code	APR-DRG 2232
Min. Negotiated Rate	$17,653.00
Max. Negotiated Rate	$57,336.34
Rate for Payer: Amida Care Medicaid	$25,482.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,482.82
Rate for Payer: Fidelis Qualified Health Plan	$30,579.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,482.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,482.82
Rate for Payer: Healthfirst Commercial	$29,722.00
Rate for Payer: Healthfirst Essential Plan	$57,336.34
Rate for Payer: Healthfirst QHP	$17,653.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,482.82
Rate for Payer: SOMOS Essential	$57,336.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,482.82

APR-DRG 2233: Other small & large bowel procedures

Facility IP

$76,431.04

Service Code	APR-DRG 2233
Min. Negotiated Rate	$26,916.00
Max. Negotiated Rate	$76,431.04
Rate for Payer: Amida Care Medicaid	$33,969.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,969.35
Rate for Payer: Fidelis Qualified Health Plan	$40,763.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,969.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,969.35
Rate for Payer: Healthfirst Commercial	$48,107.00
Rate for Payer: Healthfirst Essential Plan	$76,431.04
Rate for Payer: Healthfirst QHP	$26,916.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,969.35
Rate for Payer: SOMOS Essential	$76,431.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,969.35

APR-DRG 2234: Other small & large bowel procedures

Facility IP

$127,754.78

Service Code	APR-DRG 2234
Min. Negotiated Rate	$56,779.90
Max. Negotiated Rate	$127,754.78
Rate for Payer: Amida Care Medicaid	$56,779.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$56,779.90
Rate for Payer: Fidelis Qualified Health Plan	$68,135.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$56,779.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$56,779.90
Rate for Payer: Healthfirst Commercial	$103,966.00
Rate for Payer: Healthfirst Essential Plan	$127,754.78
Rate for Payer: Healthfirst QHP	$63,622.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56,779.90
Rate for Payer: SOMOS Essential	$127,754.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56,779.90

APR-DRG 2241: Peritoneal adhesiolysis

Facility IP

$50,779.73

Service Code	APR-DRG 2241
Min. Negotiated Rate	$14,484.00
Max. Negotiated Rate	$50,779.73
Rate for Payer: Amida Care Medicaid	$22,568.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,568.77
Rate for Payer: Fidelis Qualified Health Plan	$27,082.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,568.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,568.77
Rate for Payer: Healthfirst Commercial	$24,015.00
Rate for Payer: Healthfirst Essential Plan	$50,779.73
Rate for Payer: Healthfirst QHP	$14,484.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,568.77
Rate for Payer: SOMOS Essential	$50,779.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,568.77

Price Transparency.

All Charges