St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 3094: Other significant hip and femur surgery

Facility IP

$130,684.86

Service Code	APR-DRG 3094
Min. Negotiated Rate	$58,082.16
Max. Negotiated Rate	$130,684.86
Rate for Payer: Amida Care Medicaid	$58,082.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$58,082.16
Rate for Payer: Fidelis Qualified Health Plan	$69,698.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$58,082.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58,082.16
Rate for Payer: Healthfirst Commercial	$98,326.00
Rate for Payer: Healthfirst Essential Plan	$130,684.86
Rate for Payer: Healthfirst QHP	$70,511.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58,082.16
Rate for Payer: SOMOS Essential	$130,684.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$58,082.16

APR-DRG 3101: Intervertebral disc excision & decompression

Facility IP

$44,801.75

Service Code	APR-DRG 3101
Min. Negotiated Rate	$10,169.00
Max. Negotiated Rate	$44,801.75
Rate for Payer: Amida Care Medicaid	$19,911.89
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,911.89
Rate for Payer: Fidelis Qualified Health Plan	$23,894.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,911.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,911.89
Rate for Payer: Healthfirst Commercial	$17,344.00
Rate for Payer: Healthfirst Essential Plan	$44,801.75
Rate for Payer: Healthfirst QHP	$10,169.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,911.89
Rate for Payer: SOMOS Essential	$44,801.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,911.89

APR-DRG 3102: Intervertebral disc excision & decompression

Facility IP

$51,135.01

Service Code	APR-DRG 3102
Min. Negotiated Rate	$13,707.00
Max. Negotiated Rate	$51,135.01
Rate for Payer: Amida Care Medicaid	$22,726.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,726.67
Rate for Payer: Fidelis Qualified Health Plan	$27,272.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,726.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,726.67
Rate for Payer: Healthfirst Commercial	$23,832.00
Rate for Payer: Healthfirst Essential Plan	$51,135.01
Rate for Payer: Healthfirst QHP	$13,707.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,726.67
Rate for Payer: SOMOS Essential	$51,135.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,726.67

APR-DRG 3103: Intervertebral disc excision & decompression

Facility IP

$74,403.20

Service Code	APR-DRG 3103
Min. Negotiated Rate	$24,369.00
Max. Negotiated Rate	$74,403.20
Rate for Payer: Amida Care Medicaid	$33,068.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,068.09
Rate for Payer: Fidelis Qualified Health Plan	$39,681.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,068.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,068.09
Rate for Payer: Healthfirst Commercial	$43,550.00
Rate for Payer: Healthfirst Essential Plan	$74,403.20
Rate for Payer: Healthfirst QHP	$24,369.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,068.09
Rate for Payer: SOMOS Essential	$74,403.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,068.09

APR-DRG 3104: Intervertebral disc excision & decompression

Facility IP

$149,980.05

Service Code	APR-DRG 3104
Min. Negotiated Rate	$63,856.00
Max. Negotiated Rate	$149,980.05
Rate for Payer: Amida Care Medicaid	$66,657.80
Rate for Payer: Fidelis CHP/HARP/Medicaid	$66,657.80
Rate for Payer: Fidelis Qualified Health Plan	$79,989.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$66,657.80
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$66,657.80
Rate for Payer: Healthfirst Commercial	$102,905.00
Rate for Payer: Healthfirst Essential Plan	$149,980.05
Rate for Payer: Healthfirst QHP	$63,856.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$66,657.80
Rate for Payer: SOMOS Essential	$149,980.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$66,657.80

APR-DRG 3121: Skin graft, except hand, for musculoskeletal & connective tissue diagnoses

Facility IP

$51,080.47

Service Code	APR-DRG 3121
Min. Negotiated Rate	$22,702.43
Max. Negotiated Rate	$51,080.47
Rate for Payer: Amida Care Medicaid	$22,702.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,702.43
Rate for Payer: Fidelis Qualified Health Plan	$27,242.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,702.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,702.43
Rate for Payer: Healthfirst Commercial	$37,824.00
Rate for Payer: Healthfirst Essential Plan	$51,080.47
Rate for Payer: Healthfirst QHP	$22,940.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,702.43
Rate for Payer: SOMOS Essential	$51,080.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,702.43

APR-DRG 3122: Skin graft, except hand, for musculoskeletal & connective tissue diagnoses

Facility IP

$69,272.96

Service Code	APR-DRG 3122
Min. Negotiated Rate	$30,787.98
Max. Negotiated Rate	$69,272.96
Rate for Payer: Amida Care Medicaid	$30,787.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,787.98
Rate for Payer: Fidelis Qualified Health Plan	$36,945.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,787.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,787.98
Rate for Payer: Healthfirst Commercial	$56,870.00
Rate for Payer: Healthfirst Essential Plan	$69,272.96
Rate for Payer: Healthfirst QHP	$34,190.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,787.98
Rate for Payer: SOMOS Essential	$69,272.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,787.98

APR-DRG 3123: Skin graft, except hand, for musculoskeletal & connective tissue diagnoses

Facility IP

$116,572.00

Service Code	APR-DRG 3123
Min. Negotiated Rate	$48,566.17
Max. Negotiated Rate	$116,572.00
Rate for Payer: Amida Care Medicaid	$48,566.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$48,566.17
Rate for Payer: Fidelis Qualified Health Plan	$58,279.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$48,566.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$48,566.17
Rate for Payer: Healthfirst Commercial	$116,572.00
Rate for Payer: Healthfirst Essential Plan	$109,273.88
Rate for Payer: Healthfirst QHP	$71,707.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48,566.17
Rate for Payer: SOMOS Essential	$109,273.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48,566.17

APR-DRG 3124: Skin graft, except hand, for musculoskeletal & connective tissue diagnoses

Facility IP

$278,771.00

Service Code	APR-DRG 3124
Min. Negotiated Rate	$83,542.55
Max. Negotiated Rate	$278,771.00
Rate for Payer: Amida Care Medicaid	$83,542.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$83,542.55
Rate for Payer: Fidelis Qualified Health Plan	$100,251.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$83,542.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$83,542.55
Rate for Payer: Healthfirst Commercial	$278,771.00
Rate for Payer: Healthfirst Essential Plan	$187,970.74
Rate for Payer: Healthfirst QHP	$194,370.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$83,542.55
Rate for Payer: SOMOS Essential	$187,970.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$83,542.55

APR-DRG 3131: Knee & lower leg procedures except foot

Facility IP

$50,683.00

Service Code	APR-DRG 3131
Min. Negotiated Rate	$12,495.00
Max. Negotiated Rate	$50,683.00
Rate for Payer: Amida Care Medicaid	$22,525.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,525.78
Rate for Payer: Fidelis Qualified Health Plan	$27,030.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,525.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,525.78
Rate for Payer: Healthfirst Commercial	$21,364.00
Rate for Payer: Healthfirst Essential Plan	$50,683.00
Rate for Payer: Healthfirst QHP	$12,495.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,525.78
Rate for Payer: SOMOS Essential	$50,683.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,525.78

APR-DRG 3132: Knee & lower leg procedures except foot

Facility IP

$60,519.67

Service Code	APR-DRG 3132
Min. Negotiated Rate	$17,921.00
Max. Negotiated Rate	$60,519.67
Rate for Payer: Amida Care Medicaid	$26,897.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,897.63
Rate for Payer: Fidelis Qualified Health Plan	$32,277.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,897.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,897.63
Rate for Payer: Healthfirst Commercial	$31,012.00
Rate for Payer: Healthfirst Essential Plan	$60,519.67
Rate for Payer: Healthfirst QHP	$17,921.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,897.63
Rate for Payer: SOMOS Essential	$60,519.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,897.63

APR-DRG 3133: Knee & lower leg procedures except foot

Facility IP

$80,207.08

Service Code	APR-DRG 3133
Min. Negotiated Rate	$30,380.00
Max. Negotiated Rate	$80,207.08
Rate for Payer: Amida Care Medicaid	$35,647.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,647.59
Rate for Payer: Fidelis Qualified Health Plan	$42,777.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,647.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,647.59
Rate for Payer: Healthfirst Commercial	$51,432.00
Rate for Payer: Healthfirst Essential Plan	$80,207.08
Rate for Payer: Healthfirst QHP	$30,380.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,647.59
Rate for Payer: SOMOS Essential	$80,207.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,647.59

APR-DRG 3134: Knee & lower leg procedures except foot

Facility IP

$143,456.87

Service Code	APR-DRG 3134
Min. Negotiated Rate	$63,758.61
Max. Negotiated Rate	$143,456.87
Rate for Payer: Amida Care Medicaid	$63,758.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$63,758.61
Rate for Payer: Fidelis Qualified Health Plan	$76,510.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$63,758.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$63,758.61
Rate for Payer: Healthfirst Commercial	$124,114.00
Rate for Payer: Healthfirst Essential Plan	$143,456.87
Rate for Payer: Healthfirst QHP	$72,793.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$63,758.61
Rate for Payer: SOMOS Essential	$143,456.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$63,758.61

APR-DRG 3141: Foot & toe procedures

Facility IP

$48,257.68

Service Code	APR-DRG 3141
Min. Negotiated Rate	$10,515.00
Max. Negotiated Rate	$48,257.68
Rate for Payer: Amida Care Medicaid	$21,447.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,447.86
Rate for Payer: Fidelis Qualified Health Plan	$25,737.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,447.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,447.86
Rate for Payer: Healthfirst Commercial	$18,348.00
Rate for Payer: Healthfirst Essential Plan	$48,257.68
Rate for Payer: Healthfirst QHP	$10,515.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,447.86
Rate for Payer: SOMOS Essential	$48,257.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,447.86

APR-DRG 3142: Foot & toe procedures

Facility IP

$53,461.82

Service Code	APR-DRG 3142
Min. Negotiated Rate	$13,062.00
Max. Negotiated Rate	$53,461.82
Rate for Payer: Amida Care Medicaid	$23,760.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,760.81
Rate for Payer: Fidelis Qualified Health Plan	$28,512.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,760.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,760.81
Rate for Payer: Healthfirst Commercial	$23,317.00
Rate for Payer: Healthfirst Essential Plan	$53,461.82
Rate for Payer: Healthfirst QHP	$13,062.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,760.81
Rate for Payer: SOMOS Essential	$53,461.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,760.81

APR-DRG 3143: Foot & toe procedures

Facility IP

$65,391.39

Service Code	APR-DRG 3143
Min. Negotiated Rate	$18,873.00
Max. Negotiated Rate	$65,391.39
Rate for Payer: Amida Care Medicaid	$29,062.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,062.84
Rate for Payer: Fidelis Qualified Health Plan	$34,875.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,062.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,062.84
Rate for Payer: Healthfirst Commercial	$33,308.00
Rate for Payer: Healthfirst Essential Plan	$65,391.39
Rate for Payer: Healthfirst QHP	$18,873.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,062.84
Rate for Payer: SOMOS Essential	$65,391.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,062.84

APR-DRG 3144: Foot & toe procedures

Facility IP

$97,266.92

Service Code	APR-DRG 3144
Min. Negotiated Rate	$35,406.00
Max. Negotiated Rate	$97,266.92
Rate for Payer: Amida Care Medicaid	$43,229.74
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,229.74
Rate for Payer: Fidelis Qualified Health Plan	$51,875.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,229.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,229.74
Rate for Payer: Healthfirst Commercial	$70,274.00
Rate for Payer: Healthfirst Essential Plan	$97,266.92
Rate for Payer: Healthfirst QHP	$35,406.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,229.74
Rate for Payer: SOMOS Essential	$97,266.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,229.74

APR-DRG 3151: Shoulder, upper arm & forearm procedures except joint replacement

Facility IP

$43,866.09

Service Code	APR-DRG 3151
Min. Negotiated Rate	$10,191.00
Max. Negotiated Rate	$43,866.09
Rate for Payer: Amida Care Medicaid	$19,496.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,496.04
Rate for Payer: Fidelis Qualified Health Plan	$23,395.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,496.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,496.04
Rate for Payer: Healthfirst Commercial	$16,719.00
Rate for Payer: Healthfirst Essential Plan	$43,866.09
Rate for Payer: Healthfirst QHP	$10,191.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,496.04
Rate for Payer: SOMOS Essential	$43,866.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,496.04

APR-DRG 3152: Shoulder, upper arm & forearm procedures except joint replacement

Facility IP

$53,966.59

Service Code	APR-DRG 3152
Min. Negotiated Rate	$15,848.00
Max. Negotiated Rate	$53,966.59
Rate for Payer: Amida Care Medicaid	$23,985.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,985.15
Rate for Payer: Fidelis Qualified Health Plan	$28,782.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,985.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,985.15
Rate for Payer: Healthfirst Commercial	$27,169.00
Rate for Payer: Healthfirst Essential Plan	$53,966.59
Rate for Payer: Healthfirst QHP	$15,848.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,985.15
Rate for Payer: SOMOS Essential	$53,966.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,985.15

APR-DRG 3153: Shoulder, upper arm & forearm procedures except joint replacement

Facility IP

$76,570.00

Service Code	APR-DRG 3153
Min. Negotiated Rate	$27,927.00
Max. Negotiated Rate	$76,570.00
Rate for Payer: Amida Care Medicaid	$34,031.11
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,031.11
Rate for Payer: Fidelis Qualified Health Plan	$40,837.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,031.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,031.11
Rate for Payer: Healthfirst Commercial	$46,033.00
Rate for Payer: Healthfirst Essential Plan	$76,570.00
Rate for Payer: Healthfirst QHP	$27,927.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,031.11
Rate for Payer: SOMOS Essential	$76,570.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,031.11

APR-DRG 3154: Shoulder, upper arm & forearm procedures except joint replacement

Facility IP

$119,926.60

Service Code	APR-DRG 3154
Min. Negotiated Rate	$53,300.71
Max. Negotiated Rate	$119,926.60
Rate for Payer: Amida Care Medicaid	$53,300.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$53,300.71
Rate for Payer: Fidelis Qualified Health Plan	$63,960.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$53,300.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$53,300.71
Rate for Payer: Healthfirst Commercial	$84,667.00
Rate for Payer: Healthfirst Essential Plan	$119,926.60
Rate for Payer: Healthfirst QHP	$56,985.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$53,300.71
Rate for Payer: SOMOS Essential	$119,926.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$53,300.71

APR-DRG 3161: Hand & wrist procedures

Facility IP

$42,244.54

Service Code	APR-DRG 3161
Min. Negotiated Rate	$7,781.00
Max. Negotiated Rate	$42,244.54
Rate for Payer: Amida Care Medicaid	$18,775.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,775.35
Rate for Payer: Fidelis Qualified Health Plan	$22,530.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,775.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,775.35
Rate for Payer: Healthfirst Commercial	$13,689.00
Rate for Payer: Healthfirst Essential Plan	$42,244.54
Rate for Payer: Healthfirst QHP	$7,781.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,775.35
Rate for Payer: SOMOS Essential	$42,244.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,775.35

APR-DRG 3162: Hand & wrist procedures

Facility IP

$50,406.88

Service Code	APR-DRG 3162
Min. Negotiated Rate	$11,299.00
Max. Negotiated Rate	$50,406.88
Rate for Payer: Amida Care Medicaid	$22,403.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,403.06
Rate for Payer: Fidelis Qualified Health Plan	$26,883.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,403.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,403.06
Rate for Payer: Healthfirst Commercial	$20,998.00
Rate for Payer: Healthfirst Essential Plan	$50,406.88
Rate for Payer: Healthfirst QHP	$11,299.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,403.06
Rate for Payer: SOMOS Essential	$50,406.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,403.06

APR-DRG 3163: Hand & wrist procedures

Facility IP

$67,158.94

Service Code	APR-DRG 3163
Min. Negotiated Rate	$20,327.00
Max. Negotiated Rate	$67,158.94
Rate for Payer: Amida Care Medicaid	$29,848.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,848.42
Rate for Payer: Fidelis Qualified Health Plan	$35,818.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,848.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,848.42
Rate for Payer: Healthfirst Commercial	$36,156.00
Rate for Payer: Healthfirst Essential Plan	$67,158.94
Rate for Payer: Healthfirst QHP	$20,327.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,848.42
Rate for Payer: SOMOS Essential	$67,158.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,848.42

APR-DRG 3164: Hand & wrist procedures

Facility IP

$71,631.43

Service Code	APR-DRG 3164
Min. Negotiated Rate	$20,488.00
Max. Negotiated Rate	$71,631.43
Rate for Payer: Amida Care Medicaid	$31,836.19
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,836.19
Rate for Payer: Fidelis Qualified Health Plan	$38,203.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,836.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,836.19
Rate for Payer: Healthfirst Commercial	$36,562.00
Rate for Payer: Healthfirst Essential Plan	$71,631.43
Rate for Payer: Healthfirst QHP	$20,488.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,836.19
Rate for Payer: SOMOS Essential	$71,631.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,836.19

Price Transparency.

All Charges