St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 2792: Hepatic coma & other major acute liver disorders

Facility IP

$43,401.80

Service Code	APR-DRG 2792
Min. Negotiated Rate	$8,823.00
Max. Negotiated Rate	$43,401.80
Rate for Payer: Amida Care Medicaid	$19,289.69
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,289.69
Rate for Payer: Fidelis Qualified Health Plan	$23,147.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,289.69
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,289.69
Rate for Payer: Healthfirst Commercial	$14,956.00
Rate for Payer: Healthfirst Essential Plan	$43,401.80
Rate for Payer: Healthfirst QHP	$8,823.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,289.69
Rate for Payer: SOMOS Essential	$43,401.80
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,289.69

APR-DRG 2793: Hepatic coma & other major acute liver disorders

Facility IP

$53,521.63

Service Code	APR-DRG 2793
Min. Negotiated Rate	$13,799.00
Max. Negotiated Rate	$53,521.63
Rate for Payer: Amida Care Medicaid	$23,787.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,787.39
Rate for Payer: Fidelis Qualified Health Plan	$28,544.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,787.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,787.39
Rate for Payer: Healthfirst Commercial	$23,629.00
Rate for Payer: Healthfirst Essential Plan	$53,521.63
Rate for Payer: Healthfirst QHP	$13,799.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,787.39
Rate for Payer: SOMOS Essential	$53,521.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,787.39

APR-DRG 2794: Hepatic coma & other major acute liver disorders

Facility IP

$94,804.67

Service Code	APR-DRG 2794
Min. Negotiated Rate	$32,285.00
Max. Negotiated Rate	$94,804.67
Rate for Payer: Amida Care Medicaid	$42,135.41
Rate for Payer: Fidelis CHP/HARP/Medicaid	$42,135.41
Rate for Payer: Fidelis Qualified Health Plan	$50,562.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$42,135.41
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42,135.41
Rate for Payer: Healthfirst Commercial	$61,708.00
Rate for Payer: Healthfirst Essential Plan	$94,804.67
Rate for Payer: Healthfirst QHP	$32,285.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42,135.41
Rate for Payer: SOMOS Essential	$94,804.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$42,135.41

APR-DRG 2801: Alcoholic liver disease

Facility IP

$39,068.24

Service Code	APR-DRG 2801
Min. Negotiated Rate	$6,655.00
Max. Negotiated Rate	$39,068.24
Rate for Payer: Amida Care Medicaid	$17,363.66
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,363.66
Rate for Payer: Fidelis Qualified Health Plan	$20,836.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,363.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,363.66
Rate for Payer: Healthfirst Commercial	$10,931.00
Rate for Payer: Healthfirst Essential Plan	$39,068.24
Rate for Payer: Healthfirst QHP	$6,655.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,363.66
Rate for Payer: SOMOS Essential	$39,068.24
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,363.66

APR-DRG 2802: Alcoholic liver disease

Facility IP

$42,886.48

Service Code	APR-DRG 2802
Min. Negotiated Rate	$8,496.00
Max. Negotiated Rate	$42,886.48
Rate for Payer: Amida Care Medicaid	$19,060.66
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,060.66
Rate for Payer: Fidelis Qualified Health Plan	$22,872.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,060.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,060.66
Rate for Payer: Healthfirst Commercial	$13,429.00
Rate for Payer: Healthfirst Essential Plan	$42,886.48
Rate for Payer: Healthfirst QHP	$8,496.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,060.66
Rate for Payer: SOMOS Essential	$42,886.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,060.66

APR-DRG 2803: Alcoholic liver disease

Facility IP

$51,929.96

Service Code	APR-DRG 2803
Min. Negotiated Rate	$13,165.00
Max. Negotiated Rate	$51,929.96
Rate for Payer: Amida Care Medicaid	$23,079.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,079.98
Rate for Payer: Fidelis Qualified Health Plan	$27,695.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,079.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,079.98
Rate for Payer: Healthfirst Commercial	$21,582.00
Rate for Payer: Healthfirst Essential Plan	$51,929.96
Rate for Payer: Healthfirst QHP	$13,165.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,079.98
Rate for Payer: SOMOS Essential	$51,929.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,079.98

APR-DRG 2804: Alcoholic liver disease

Facility IP

$89,656.81

Service Code	APR-DRG 2804
Min. Negotiated Rate	$30,753.00
Max. Negotiated Rate	$89,656.81
Rate for Payer: Amida Care Medicaid	$39,847.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,847.47
Rate for Payer: Fidelis Qualified Health Plan	$47,816.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,847.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,847.47
Rate for Payer: Healthfirst Commercial	$55,076.00
Rate for Payer: Healthfirst Essential Plan	$89,656.81
Rate for Payer: Healthfirst QHP	$30,753.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,847.47
Rate for Payer: SOMOS Essential	$89,656.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,847.47

APR-DRG 2811: Malignancy of hepatobiliary system & pancreas

Facility IP

$41,375.72

Service Code	APR-DRG 2811
Min. Negotiated Rate	$7,201.00
Max. Negotiated Rate	$41,375.72
Rate for Payer: Amida Care Medicaid	$18,389.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,389.21
Rate for Payer: Fidelis Qualified Health Plan	$22,067.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,389.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,389.21
Rate for Payer: Healthfirst Commercial	$14,598.00
Rate for Payer: Healthfirst Essential Plan	$41,375.72
Rate for Payer: Healthfirst QHP	$7,201.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,389.21
Rate for Payer: SOMOS Essential	$41,375.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,389.21

APR-DRG 2812: Malignancy of hepatobiliary system & pancreas

Facility IP

$46,178.84

Service Code	APR-DRG 2812
Min. Negotiated Rate	$9,888.00
Max. Negotiated Rate	$46,178.84
Rate for Payer: Amida Care Medicaid	$20,523.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,523.93
Rate for Payer: Fidelis Qualified Health Plan	$24,628.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,523.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,523.93
Rate for Payer: Healthfirst Commercial	$16,140.00
Rate for Payer: Healthfirst Essential Plan	$46,178.84
Rate for Payer: Healthfirst QHP	$9,888.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,523.93
Rate for Payer: SOMOS Essential	$46,178.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,523.93

APR-DRG 2813: Malignancy of hepatobiliary system & pancreas

Facility IP

$53,880.41

Service Code	APR-DRG 2813
Min. Negotiated Rate	$14,629.00
Max. Negotiated Rate	$53,880.41
Rate for Payer: Amida Care Medicaid	$23,946.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,946.85
Rate for Payer: Fidelis Qualified Health Plan	$28,736.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,946.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,946.85
Rate for Payer: Healthfirst Commercial	$23,547.00
Rate for Payer: Healthfirst Essential Plan	$53,880.41
Rate for Payer: Healthfirst QHP	$14,629.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,946.85
Rate for Payer: SOMOS Essential	$53,880.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,946.85

APR-DRG 2814: Malignancy of hepatobiliary system & pancreas

Facility IP

$72,178.40

Service Code	APR-DRG 2814
Min. Negotiated Rate	$25,818.00
Max. Negotiated Rate	$72,178.40
Rate for Payer: Amida Care Medicaid	$32,079.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,079.29
Rate for Payer: Fidelis Qualified Health Plan	$38,495.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,079.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,079.29
Rate for Payer: Healthfirst Commercial	$41,439.00
Rate for Payer: Healthfirst Essential Plan	$72,178.40
Rate for Payer: Healthfirst QHP	$25,818.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,079.29
Rate for Payer: SOMOS Essential	$72,178.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,079.29

APR-DRG 2821: Disorders of pancreas except malignancy

Facility IP

$39,351.40

Service Code	APR-DRG 2821
Min. Negotiated Rate	$6,920.00
Max. Negotiated Rate	$39,351.40
Rate for Payer: Amida Care Medicaid	$17,489.51
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,489.51
Rate for Payer: Fidelis Qualified Health Plan	$20,987.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,489.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,489.51
Rate for Payer: Healthfirst Commercial	$11,427.00
Rate for Payer: Healthfirst Essential Plan	$39,351.40
Rate for Payer: Healthfirst QHP	$6,920.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,489.51
Rate for Payer: SOMOS Essential	$39,351.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,489.51

APR-DRG 2822: Disorders of pancreas except malignancy

Facility IP

$42,779.20

Service Code	APR-DRG 2822
Min. Negotiated Rate	$8,566.00
Max. Negotiated Rate	$42,779.20
Rate for Payer: Amida Care Medicaid	$19,012.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,012.98
Rate for Payer: Fidelis Qualified Health Plan	$22,815.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,012.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,012.98
Rate for Payer: Healthfirst Commercial	$14,149.00
Rate for Payer: Healthfirst Essential Plan	$42,779.20
Rate for Payer: Healthfirst QHP	$8,566.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,012.98
Rate for Payer: SOMOS Essential	$42,779.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,012.98

APR-DRG 2823: Disorders of pancreas except malignancy

Facility IP

$53,595.50

Service Code	APR-DRG 2823
Min. Negotiated Rate	$13,626.00
Max. Negotiated Rate	$53,595.50
Rate for Payer: Amida Care Medicaid	$23,820.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,820.22
Rate for Payer: Fidelis Qualified Health Plan	$28,584.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,820.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,820.22
Rate for Payer: Healthfirst Commercial	$24,384.00
Rate for Payer: Healthfirst Essential Plan	$53,595.50
Rate for Payer: Healthfirst QHP	$13,626.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,820.22
Rate for Payer: SOMOS Essential	$53,595.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,820.22

APR-DRG 2824: Disorders of pancreas except malignancy

Facility IP

$90,439.47

Service Code	APR-DRG 2824
Min. Negotiated Rate	$34,217.00
Max. Negotiated Rate	$90,439.47
Rate for Payer: Amida Care Medicaid	$40,195.32
Rate for Payer: Fidelis CHP/HARP/Medicaid	$40,195.32
Rate for Payer: Fidelis Qualified Health Plan	$48,234.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$40,195.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40,195.32
Rate for Payer: Healthfirst Commercial	$63,863.00
Rate for Payer: Healthfirst Essential Plan	$90,439.47
Rate for Payer: Healthfirst QHP	$34,217.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40,195.32
Rate for Payer: SOMOS Essential	$90,439.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40,195.32

APR-DRG 2831: Other disorders of the liver

Facility IP

$39,555.40

Service Code	APR-DRG 2831
Min. Negotiated Rate	$5,995.00
Max. Negotiated Rate	$39,555.40
Rate for Payer: Amida Care Medicaid	$17,580.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,580.18
Rate for Payer: Fidelis Qualified Health Plan	$21,096.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,580.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,580.18
Rate for Payer: Healthfirst Commercial	$11,057.00
Rate for Payer: Healthfirst Essential Plan	$39,555.40
Rate for Payer: Healthfirst QHP	$5,995.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,580.18
Rate for Payer: SOMOS Essential	$39,555.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,580.18

APR-DRG 2832: Other disorders of the liver

Facility IP

$42,786.22

Service Code	APR-DRG 2832
Min. Negotiated Rate	$8,240.00
Max. Negotiated Rate	$42,786.22
Rate for Payer: Amida Care Medicaid	$19,016.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,016.10
Rate for Payer: Fidelis Qualified Health Plan	$22,819.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,016.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,016.10
Rate for Payer: Healthfirst Commercial	$13,646.00
Rate for Payer: Healthfirst Essential Plan	$42,786.22
Rate for Payer: Healthfirst QHP	$8,240.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,016.10
Rate for Payer: SOMOS Essential	$42,786.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,016.10

APR-DRG 2833: Other disorders of the liver

Facility IP

$50,827.21

Service Code	APR-DRG 2833
Min. Negotiated Rate	$12,470.00
Max. Negotiated Rate	$50,827.21
Rate for Payer: Amida Care Medicaid	$22,589.87
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,589.87
Rate for Payer: Fidelis Qualified Health Plan	$27,107.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,589.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,589.87
Rate for Payer: Healthfirst Commercial	$20,524.00
Rate for Payer: Healthfirst Essential Plan	$50,827.21
Rate for Payer: Healthfirst QHP	$12,470.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,589.87
Rate for Payer: SOMOS Essential	$50,827.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,589.87

APR-DRG 2834: Other disorders of the liver

Facility IP

$75,189.38

Service Code	APR-DRG 2834
Min. Negotiated Rate	$26,638.00
Max. Negotiated Rate	$75,189.38
Rate for Payer: Amida Care Medicaid	$33,417.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,417.50
Rate for Payer: Fidelis Qualified Health Plan	$40,101.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,417.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,417.50
Rate for Payer: Healthfirst Commercial	$46,116.00
Rate for Payer: Healthfirst Essential Plan	$75,189.38
Rate for Payer: Healthfirst QHP	$26,638.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,417.50
Rate for Payer: SOMOS Essential	$75,189.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,417.50

APR-DRG 2841: Disorders of gallbladder & biliary tract

Facility IP

$39,801.64

Service Code	APR-DRG 2841
Min. Negotiated Rate	$6,492.00
Max. Negotiated Rate	$39,801.64
Rate for Payer: Amida Care Medicaid	$17,689.62
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,689.62
Rate for Payer: Fidelis Qualified Health Plan	$21,227.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,689.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,689.62
Rate for Payer: Healthfirst Commercial	$11,009.00
Rate for Payer: Healthfirst Essential Plan	$39,801.64
Rate for Payer: Healthfirst QHP	$6,492.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,689.62
Rate for Payer: SOMOS Essential	$39,801.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,689.62

APR-DRG 2842: Disorders of gallbladder & biliary tract

Facility IP

$44,198.50

Service Code	APR-DRG 2842
Min. Negotiated Rate	$8,769.00
Max. Negotiated Rate	$44,198.50
Rate for Payer: Amida Care Medicaid	$19,643.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,643.78
Rate for Payer: Fidelis Qualified Health Plan	$23,572.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,643.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,643.78
Rate for Payer: Healthfirst Commercial	$14,966.00
Rate for Payer: Healthfirst Essential Plan	$44,198.50
Rate for Payer: Healthfirst QHP	$8,769.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,643.78
Rate for Payer: SOMOS Essential	$44,198.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,643.78

APR-DRG 2843: Disorders of gallbladder & biliary tract

Facility IP

$52,821.63

Service Code	APR-DRG 2843
Min. Negotiated Rate	$13,092.00
Max. Negotiated Rate	$52,821.63
Rate for Payer: Amida Care Medicaid	$23,476.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,476.28
Rate for Payer: Fidelis Qualified Health Plan	$28,171.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,476.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,476.28
Rate for Payer: Healthfirst Commercial	$22,343.00
Rate for Payer: Healthfirst Essential Plan	$52,821.63
Rate for Payer: Healthfirst QHP	$13,092.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,476.28
Rate for Payer: SOMOS Essential	$52,821.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,476.28

APR-DRG 2844: Disorders of gallbladder & biliary tract

Facility IP

$81,775.87

Service Code	APR-DRG 2844
Min. Negotiated Rate	$24,933.00
Max. Negotiated Rate	$81,775.87
Rate for Payer: Amida Care Medicaid	$36,344.83
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,344.83
Rate for Payer: Fidelis Qualified Health Plan	$43,613.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,344.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,344.83
Rate for Payer: Healthfirst Commercial	$47,926.00
Rate for Payer: Healthfirst Essential Plan	$81,775.87
Rate for Payer: Healthfirst QHP	$24,933.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,344.83
Rate for Payer: SOMOS Essential	$81,775.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,344.83

APR-DRG 3011: Hip joint replacement

Facility IP

$62,099.03

Service Code	APR-DRG 3011
Min. Negotiated Rate	$23,799.00
Max. Negotiated Rate	$62,099.03
Rate for Payer: Amida Care Medicaid	$27,599.57
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,599.57
Rate for Payer: Fidelis Qualified Health Plan	$33,119.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,599.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,599.57
Rate for Payer: Healthfirst Commercial	$37,492.00
Rate for Payer: Healthfirst Essential Plan	$62,099.03
Rate for Payer: Healthfirst QHP	$23,799.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,599.57
Rate for Payer: SOMOS Essential	$62,099.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,599.57

APR-DRG 3012: Hip joint replacement

Facility IP

$63,374.11

Service Code	APR-DRG 3012
Min. Negotiated Rate	$24,742.00
Max. Negotiated Rate	$63,374.11
Rate for Payer: Amida Care Medicaid	$28,166.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,166.27
Rate for Payer: Fidelis Qualified Health Plan	$33,799.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,166.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,166.27
Rate for Payer: Healthfirst Commercial	$39,066.00
Rate for Payer: Healthfirst Essential Plan	$63,374.11
Rate for Payer: Healthfirst QHP	$24,742.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,166.27
Rate for Payer: SOMOS Essential	$63,374.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,166.27

Price Transparency.

All Charges