APR-DRG 3171: Tendon, muscle & other soft tissue procedures
|
Facility
IP
|
$45,468.32
|
|
Service Code
|
APR-DRG 3171
|
Min. Negotiated Rate |
$10,079.00 |
Max. Negotiated Rate |
$45,468.32 |
Rate for Payer: Amida Care Medicaid |
$20,208.14
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,208.14
|
Rate for Payer: Fidelis Qualified Health Plan |
$24,249.77
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,208.14
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,208.14
|
Rate for Payer: Healthfirst Commercial |
$17,202.00
|
Rate for Payer: Healthfirst Essential Plan |
$45,468.32
|
Rate for Payer: Healthfirst QHP |
$10,079.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,208.14
|
Rate for Payer: SOMOS Essential |
$45,468.32
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,208.14
|
|
APR-DRG 3172: Tendon, muscle & other soft tissue procedures
|
Facility
IP
|
$54,879.37
|
|
Service Code
|
APR-DRG 3172
|
Min. Negotiated Rate |
$16,179.00 |
Max. Negotiated Rate |
$54,879.37 |
Rate for Payer: Amida Care Medicaid |
$24,390.83
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,390.83
|
Rate for Payer: Fidelis Qualified Health Plan |
$29,269.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,390.83
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,390.83
|
Rate for Payer: Healthfirst Commercial |
$27,090.00
|
Rate for Payer: Healthfirst Essential Plan |
$54,879.37
|
Rate for Payer: Healthfirst QHP |
$16,179.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,390.83
|
Rate for Payer: SOMOS Essential |
$54,879.37
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,390.83
|
|
APR-DRG 3173: Tendon, muscle & other soft tissue procedures
|
Facility
IP
|
$75,507.70
|
|
Service Code
|
APR-DRG 3173
|
Min. Negotiated Rate |
$26,951.00 |
Max. Negotiated Rate |
$75,507.70 |
Rate for Payer: Amida Care Medicaid |
$33,558.98
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33,558.98
|
Rate for Payer: Fidelis Qualified Health Plan |
$40,270.78
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$33,558.98
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33,558.98
|
Rate for Payer: Healthfirst Commercial |
$46,551.00
|
Rate for Payer: Healthfirst Essential Plan |
$75,507.70
|
Rate for Payer: Healthfirst QHP |
$26,951.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33,558.98
|
Rate for Payer: SOMOS Essential |
$75,507.70
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33,558.98
|
|
APR-DRG 3174: Tendon, muscle & other soft tissue procedures
|
Facility
IP
|
$140,760.70
|
|
Service Code
|
APR-DRG 3174
|
Min. Negotiated Rate |
$62,560.31 |
Max. Negotiated Rate |
$140,760.70 |
Rate for Payer: Amida Care Medicaid |
$62,560.31
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$62,560.31
|
Rate for Payer: Fidelis Qualified Health Plan |
$75,072.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$62,560.31
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$62,560.31
|
Rate for Payer: Healthfirst Commercial |
$121,158.00
|
Rate for Payer: Healthfirst Essential Plan |
$140,760.70
|
Rate for Payer: Healthfirst QHP |
$66,772.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$62,560.31
|
Rate for Payer: SOMOS Essential |
$140,760.70
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$62,560.31
|
|
APR-DRG 3201: Other musculoskeletal system & connective tissue procedures
|
Facility
IP
|
$47,677.30
|
|
Service Code
|
APR-DRG 3201
|
Min. Negotiated Rate |
$10,743.00 |
Max. Negotiated Rate |
$47,677.30 |
Rate for Payer: Amida Care Medicaid |
$21,189.91
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21,189.91
|
Rate for Payer: Fidelis Qualified Health Plan |
$25,427.89
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$21,189.91
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21,189.91
|
Rate for Payer: Healthfirst Commercial |
$18,516.00
|
Rate for Payer: Healthfirst Essential Plan |
$47,677.30
|
Rate for Payer: Healthfirst QHP |
$10,743.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21,189.91
|
Rate for Payer: SOMOS Essential |
$47,677.30
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,189.91
|
|
APR-DRG 3202: Other musculoskeletal system & connective tissue procedures
|
Facility
IP
|
$58,271.98
|
|
Service Code
|
APR-DRG 3202
|
Min. Negotiated Rate |
$17,953.00 |
Max. Negotiated Rate |
$58,271.98 |
Rate for Payer: Amida Care Medicaid |
$25,898.66
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,898.66
|
Rate for Payer: Fidelis Qualified Health Plan |
$31,078.39
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,898.66
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,898.66
|
Rate for Payer: Healthfirst Commercial |
$30,130.00
|
Rate for Payer: Healthfirst Essential Plan |
$58,271.98
|
Rate for Payer: Healthfirst QHP |
$17,953.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,898.66
|
Rate for Payer: SOMOS Essential |
$58,271.98
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,898.66
|
|
APR-DRG 3203: Other musculoskeletal system & connective tissue procedures
|
Facility
IP
|
$73,873.82
|
|
Service Code
|
APR-DRG 3203
|
Min. Negotiated Rate |
$27,682.00 |
Max. Negotiated Rate |
$73,873.82 |
Rate for Payer: Amida Care Medicaid |
$32,832.81
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32,832.81
|
Rate for Payer: Fidelis Qualified Health Plan |
$39,399.37
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$32,832.81
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32,832.81
|
Rate for Payer: Healthfirst Commercial |
$47,919.00
|
Rate for Payer: Healthfirst Essential Plan |
$73,873.82
|
Rate for Payer: Healthfirst QHP |
$27,682.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32,832.81
|
Rate for Payer: SOMOS Essential |
$73,873.82
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$32,832.81
|
|
APR-DRG 3204: Other musculoskeletal system & connective tissue procedures
|
Facility
IP
|
$117,643.75
|
|
Service Code
|
APR-DRG 3204
|
Min. Negotiated Rate |
$52,286.11 |
Max. Negotiated Rate |
$117,643.75 |
Rate for Payer: Amida Care Medicaid |
$52,286.11
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$52,286.11
|
Rate for Payer: Fidelis Qualified Health Plan |
$62,743.33
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$52,286.11
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$52,286.11
|
Rate for Payer: Healthfirst Commercial |
$107,294.00
|
Rate for Payer: Healthfirst Essential Plan |
$117,643.75
|
Rate for Payer: Healthfirst QHP |
$71,428.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$52,286.11
|
Rate for Payer: SOMOS Essential |
$117,643.75
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$52,286.11
|
|
APR-DRG 3211: Cervical spinal fusion & other back/neck proc exc disc excis/decomp
|
Facility
IP
|
$58,340.59
|
|
Service Code
|
APR-DRG 3211
|
Min. Negotiated Rate |
$19,121.00 |
Max. Negotiated Rate |
$58,340.59 |
Rate for Payer: Amida Care Medicaid |
$25,929.15
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,929.15
|
Rate for Payer: Fidelis Qualified Health Plan |
$31,114.98
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,929.15
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,929.15
|
Rate for Payer: Healthfirst Commercial |
$31,053.00
|
Rate for Payer: Healthfirst Essential Plan |
$58,340.59
|
Rate for Payer: Healthfirst QHP |
$19,121.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,929.15
|
Rate for Payer: SOMOS Essential |
$58,340.59
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,929.15
|
|
APR-DRG 3212: Cervical spinal fusion & other back/neck proc exc disc excis/decomp
|
Facility
IP
|
$67,405.16
|
|
Service Code
|
APR-DRG 3212
|
Min. Negotiated Rate |
$24,410.00 |
Max. Negotiated Rate |
$67,405.16 |
Rate for Payer: Amida Care Medicaid |
$29,957.85
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29,957.85
|
Rate for Payer: Fidelis Qualified Health Plan |
$35,949.42
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$29,957.85
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29,957.85
|
Rate for Payer: Healthfirst Commercial |
$41,505.00
|
Rate for Payer: Healthfirst Essential Plan |
$67,405.16
|
Rate for Payer: Healthfirst QHP |
$24,410.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29,957.85
|
Rate for Payer: SOMOS Essential |
$67,405.16
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29,957.85
|
|
APR-DRG 3213: Cervical spinal fusion & other back/neck proc exc disc excis/decomp
|
Facility
IP
|
$94,762.46
|
|
Service Code
|
APR-DRG 3213
|
Min. Negotiated Rate |
$42,116.65 |
Max. Negotiated Rate |
$94,762.46 |
Rate for Payer: Amida Care Medicaid |
$42,116.65
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$42,116.65
|
Rate for Payer: Fidelis Qualified Health Plan |
$50,539.98
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$42,116.65
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42,116.65
|
Rate for Payer: Healthfirst Commercial |
$71,586.00
|
Rate for Payer: Healthfirst Essential Plan |
$94,762.46
|
Rate for Payer: Healthfirst QHP |
$45,114.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$42,116.65
|
Rate for Payer: SOMOS Essential |
$94,762.46
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$42,116.65
|
|
APR-DRG 3214: Cervical spinal fusion & other back/neck proc exc disc excis/decomp
|
Facility
IP
|
$153,884.48
|
|
Service Code
|
APR-DRG 3214
|
Min. Negotiated Rate |
$68,393.10 |
Max. Negotiated Rate |
$153,884.48 |
Rate for Payer: Amida Care Medicaid |
$68,393.10
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$68,393.10
|
Rate for Payer: Fidelis Qualified Health Plan |
$82,071.72
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$68,393.10
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$68,393.10
|
Rate for Payer: Healthfirst Commercial |
$140,740.00
|
Rate for Payer: Healthfirst Essential Plan |
$153,884.48
|
Rate for Payer: Healthfirst QHP |
$85,302.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$68,393.10
|
Rate for Payer: SOMOS Essential |
$153,884.48
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$68,393.10
|
|
APR-DRG 3221: Shoulder & elbow joint replacement #
|
Facility
IP
|
$57,436.58
|
|
Service Code
|
APR-DRG 3221
|
Min. Negotiated Rate |
$25,527.37 |
Max. Negotiated Rate |
$57,436.58 |
Rate for Payer: Amida Care Medicaid |
$25,527.37
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,527.37
|
Rate for Payer: Fidelis Qualified Health Plan |
$30,632.84
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,527.37
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,527.37
|
Rate for Payer: Healthfirst Essential Plan |
$57,436.58
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,527.37
|
Rate for Payer: SOMOS Essential |
$57,436.58
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,527.37
|
|
APR-DRG 3222: Shoulder & elbow joint replacement #
|
Facility
IP
|
$60,343.78
|
|
Service Code
|
APR-DRG 3222
|
Min. Negotiated Rate |
$26,819.46 |
Max. Negotiated Rate |
$60,343.78 |
Rate for Payer: Amida Care Medicaid |
$26,819.46
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26,819.46
|
Rate for Payer: Fidelis Qualified Health Plan |
$32,183.35
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$26,819.46
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26,819.46
|
Rate for Payer: Healthfirst Essential Plan |
$60,343.78
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26,819.46
|
Rate for Payer: SOMOS Essential |
$60,343.78
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$26,819.46
|
|
APR-DRG 3223: Shoulder & elbow joint replacement #
|
Facility
IP
|
$81,061.83
|
|
Service Code
|
APR-DRG 3223
|
Min. Negotiated Rate |
$36,027.48 |
Max. Negotiated Rate |
$81,061.83 |
Rate for Payer: Amida Care Medicaid |
$36,027.48
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36,027.48
|
Rate for Payer: Fidelis Qualified Health Plan |
$43,232.98
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$36,027.48
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36,027.48
|
Rate for Payer: Healthfirst Essential Plan |
$81,061.83
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$36,027.48
|
Rate for Payer: SOMOS Essential |
$81,061.83
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$36,027.48
|
|
APR-DRG 3224: Shoulder & elbow joint replacement #
|
Facility
IP
|
$89,764.11
|
|
Service Code
|
APR-DRG 3224
|
Min. Negotiated Rate |
$39,895.16 |
Max. Negotiated Rate |
$89,764.11 |
Rate for Payer: Amida Care Medicaid |
$39,895.16
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39,895.16
|
Rate for Payer: Fidelis Qualified Health Plan |
$47,874.19
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$39,895.16
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39,895.16
|
Rate for Payer: Healthfirst Essential Plan |
$89,764.11
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39,895.16
|
Rate for Payer: SOMOS Essential |
$89,764.11
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$39,895.16
|
|
APR-DRG 3401: Fracture of femur
|
Facility
IP
|
$38,941.60
|
|
Service Code
|
APR-DRG 3401
|
Min. Negotiated Rate |
$7,074.00 |
Max. Negotiated Rate |
$38,941.60 |
Rate for Payer: Amida Care Medicaid |
$17,307.38
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17,307.38
|
Rate for Payer: Fidelis Qualified Health Plan |
$20,768.86
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$17,307.38
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17,307.38
|
Rate for Payer: Healthfirst Commercial |
$11,587.00
|
Rate for Payer: Healthfirst Essential Plan |
$38,941.60
|
Rate for Payer: Healthfirst QHP |
$7,074.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17,307.38
|
Rate for Payer: SOMOS Essential |
$38,941.60
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17,307.38
|
|
APR-DRG 3402: Fracture of femur
|
Facility
IP
|
$42,096.80
|
|
Service Code
|
APR-DRG 3402
|
Min. Negotiated Rate |
$8,238.00 |
Max. Negotiated Rate |
$42,096.80 |
Rate for Payer: Amida Care Medicaid |
$18,709.69
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,709.69
|
Rate for Payer: Fidelis Qualified Health Plan |
$22,451.63
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,709.69
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,709.69
|
Rate for Payer: Healthfirst Commercial |
$13,300.00
|
Rate for Payer: Healthfirst Essential Plan |
$42,096.80
|
Rate for Payer: Healthfirst QHP |
$8,238.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,709.69
|
Rate for Payer: SOMOS Essential |
$42,096.80
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,709.69
|
|
APR-DRG 3403: Fracture of femur
|
Facility
IP
|
$59,603.36
|
|
Service Code
|
APR-DRG 3403
|
Min. Negotiated Rate |
$13,069.00 |
Max. Negotiated Rate |
$59,603.36 |
Rate for Payer: Amida Care Medicaid |
$26,490.38
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26,490.38
|
Rate for Payer: Fidelis Qualified Health Plan |
$31,788.46
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$26,490.38
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26,490.38
|
Rate for Payer: Healthfirst Commercial |
$19,303.00
|
Rate for Payer: Healthfirst Essential Plan |
$59,603.36
|
Rate for Payer: Healthfirst QHP |
$13,069.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26,490.38
|
Rate for Payer: SOMOS Essential |
$59,603.36
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$26,490.38
|
|
APR-DRG 3404: Fracture of femur
|
Facility
IP
|
$70,412.62
|
|
Service Code
|
APR-DRG 3404
|
Min. Negotiated Rate |
$25,036.00 |
Max. Negotiated Rate |
$70,412.62 |
Rate for Payer: Amida Care Medicaid |
$31,294.50
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31,294.50
|
Rate for Payer: Fidelis Qualified Health Plan |
$37,553.40
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$31,294.50
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31,294.50
|
Rate for Payer: Healthfirst Commercial |
$38,321.00
|
Rate for Payer: Healthfirst Essential Plan |
$70,412.62
|
Rate for Payer: Healthfirst QHP |
$25,036.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31,294.50
|
Rate for Payer: SOMOS Essential |
$70,412.62
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$31,294.50
|
|
APR-DRG 3411: Fracture of pelvis or dislocation of hip
|
Facility
IP
|
$39,711.94
|
|
Service Code
|
APR-DRG 3411
|
Min. Negotiated Rate |
$6,475.00 |
Max. Negotiated Rate |
$39,711.94 |
Rate for Payer: Amida Care Medicaid |
$17,649.75
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17,649.75
|
Rate for Payer: Fidelis Qualified Health Plan |
$21,179.70
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$17,649.75
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17,649.75
|
Rate for Payer: Healthfirst Commercial |
$11,025.00
|
Rate for Payer: Healthfirst Essential Plan |
$39,711.94
|
Rate for Payer: Healthfirst QHP |
$6,475.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17,649.75
|
Rate for Payer: SOMOS Essential |
$39,711.94
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$17,649.75
|
|
APR-DRG 3412: Fracture of pelvis or dislocation of hip
|
Facility
IP
|
$42,197.04
|
|
Service Code
|
APR-DRG 3412
|
Min. Negotiated Rate |
$8,423.00 |
Max. Negotiated Rate |
$42,197.04 |
Rate for Payer: Amida Care Medicaid |
$18,754.24
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,754.24
|
Rate for Payer: Fidelis Qualified Health Plan |
$22,505.09
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,754.24
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,754.24
|
Rate for Payer: Healthfirst Commercial |
$13,501.00
|
Rate for Payer: Healthfirst Essential Plan |
$42,197.04
|
Rate for Payer: Healthfirst QHP |
$8,423.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,754.24
|
Rate for Payer: SOMOS Essential |
$42,197.04
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,754.24
|
|
APR-DRG 3413: Fracture of pelvis or dislocation of hip
|
Facility
IP
|
$46,564.02
|
|
Service Code
|
APR-DRG 3413
|
Min. Negotiated Rate |
$11,554.00 |
Max. Negotiated Rate |
$46,564.02 |
Rate for Payer: Amida Care Medicaid |
$20,695.12
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,695.12
|
Rate for Payer: Fidelis Qualified Health Plan |
$24,834.14
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,695.12
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,695.12
|
Rate for Payer: Healthfirst Commercial |
$20,398.00
|
Rate for Payer: Healthfirst Essential Plan |
$46,564.02
|
Rate for Payer: Healthfirst QHP |
$11,554.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,695.12
|
Rate for Payer: SOMOS Essential |
$46,564.02
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,695.12
|
|
APR-DRG 3414: Fracture of pelvis or dislocation of hip
|
Facility
IP
|
$47,649.17
|
|
Service Code
|
APR-DRG 3414
|
Min. Negotiated Rate |
$21,177.41 |
Max. Negotiated Rate |
$47,649.17 |
Rate for Payer: Amida Care Medicaid |
$21,177.41
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21,177.41
|
Rate for Payer: Fidelis Qualified Health Plan |
$25,412.89
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$21,177.41
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21,177.41
|
Rate for Payer: Healthfirst Commercial |
$44,058.00
|
Rate for Payer: Healthfirst Essential Plan |
$47,649.17
|
Rate for Payer: Healthfirst QHP |
$25,272.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21,177.41
|
Rate for Payer: SOMOS Essential |
$47,649.17
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,177.41
|
|
APR-DRG 3421: Fractures & dislocations except femur, pelvis & back
|
Facility
IP
|
$37,462.50
|
|
Service Code
|
APR-DRG 3421
|
Min. Negotiated Rate |
$5,490.00 |
Max. Negotiated Rate |
$37,462.50 |
Rate for Payer: Amida Care Medicaid |
$16,650.00
|
Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16,650.00
|
Rate for Payer: Fidelis Qualified Health Plan |
$19,980.00
|
Rate for Payer: Hamaspik Choice Inc Medicaid |
$16,650.00
|
Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16,650.00
|
Rate for Payer: Healthfirst Commercial |
$9,443.00
|
Rate for Payer: Healthfirst Essential Plan |
$37,462.50
|
Rate for Payer: Healthfirst QHP |
$5,490.00
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16,650.00
|
Rate for Payer: SOMOS Essential |
$37,462.50
|
Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16,650.00
|
|