St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 3814: Major skin disorders

Facility IP

$133,458.39

Service Code	APR-DRG 3814
Min. Negotiated Rate	$36,987.00
Max. Negotiated Rate	$133,458.39
Rate for Payer: Amida Care Medicaid	$59,314.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59,314.84
Rate for Payer: Fidelis Qualified Health Plan	$71,177.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$59,314.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$59,314.84
Rate for Payer: Healthfirst Commercial	$64,683.00
Rate for Payer: Healthfirst Essential Plan	$133,458.39
Rate for Payer: Healthfirst QHP	$36,987.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59,314.84
Rate for Payer: SOMOS Essential	$133,458.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$59,314.84

APR-DRG 3821: Malignant breast disorders

Facility IP

$40,591.30

Service Code	APR-DRG 3821
Min. Negotiated Rate	$5,233.00
Max. Negotiated Rate	$40,591.30
Rate for Payer: Amida Care Medicaid	$18,040.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,040.58
Rate for Payer: Fidelis Qualified Health Plan	$21,648.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,040.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,040.58
Rate for Payer: Healthfirst Commercial	$11,585.00
Rate for Payer: Healthfirst Essential Plan	$40,591.30
Rate for Payer: Healthfirst QHP	$5,233.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,040.58
Rate for Payer: SOMOS Essential	$40,591.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,040.58

APR-DRG 3822: Malignant breast disorders

Facility IP

$44,300.52

Service Code	APR-DRG 3822
Min. Negotiated Rate	$9,349.00
Max. Negotiated Rate	$44,300.52
Rate for Payer: Amida Care Medicaid	$19,689.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,689.12
Rate for Payer: Fidelis Qualified Health Plan	$23,626.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,689.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,689.12
Rate for Payer: Healthfirst Commercial	$14,137.00
Rate for Payer: Healthfirst Essential Plan	$44,300.52
Rate for Payer: Healthfirst QHP	$9,349.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,689.12
Rate for Payer: SOMOS Essential	$44,300.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,689.12

APR-DRG 3823: Malignant breast disorders

Facility IP

$56,131.60

Service Code	APR-DRG 3823
Min. Negotiated Rate	$15,775.00
Max. Negotiated Rate	$56,131.60
Rate for Payer: Amida Care Medicaid	$24,947.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,947.38
Rate for Payer: Fidelis Qualified Health Plan	$29,936.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,947.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,947.38
Rate for Payer: Healthfirst Commercial	$25,820.00
Rate for Payer: Healthfirst Essential Plan	$56,131.60
Rate for Payer: Healthfirst QHP	$15,775.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,947.38
Rate for Payer: SOMOS Essential	$56,131.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,947.38

APR-DRG 3824: Malignant breast disorders

Facility IP

$80,535.96

Service Code	APR-DRG 3824
Min. Negotiated Rate	$25,699.00
Max. Negotiated Rate	$80,535.96
Rate for Payer: Amida Care Medicaid	$35,793.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,793.76
Rate for Payer: Fidelis Qualified Health Plan	$42,952.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,793.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,793.76
Rate for Payer: Healthfirst Commercial	$52,143.00
Rate for Payer: Healthfirst Essential Plan	$80,535.96
Rate for Payer: Healthfirst QHP	$25,699.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,793.76
Rate for Payer: SOMOS Essential	$80,535.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,793.76

APR-DRG 3831: Cellulitis & other skin infections

Facility IP

$38,526.55

Service Code	APR-DRG 3831
Min. Negotiated Rate	$5,956.00
Max. Negotiated Rate	$38,526.55
Rate for Payer: Amida Care Medicaid	$17,122.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,122.91
Rate for Payer: Fidelis Qualified Health Plan	$20,547.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,122.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,122.91
Rate for Payer: Healthfirst Commercial	$10,277.00
Rate for Payer: Healthfirst Essential Plan	$38,526.55
Rate for Payer: Healthfirst QHP	$5,956.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,122.91
Rate for Payer: SOMOS Essential	$38,526.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,122.91

APR-DRG 3832: Cellulitis & other skin infections

Facility IP

$41,676.46

Service Code	APR-DRG 3832
Min. Negotiated Rate	$7,771.00
Max. Negotiated Rate	$41,676.46
Rate for Payer: Amida Care Medicaid	$18,522.87
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,522.87
Rate for Payer: Fidelis Qualified Health Plan	$22,227.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,522.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,522.87
Rate for Payer: Healthfirst Commercial	$13,299.00
Rate for Payer: Healthfirst Essential Plan	$41,676.46
Rate for Payer: Healthfirst QHP	$7,771.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,522.87
Rate for Payer: SOMOS Essential	$41,676.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,522.87

APR-DRG 3833: Cellulitis & other skin infections

Facility IP

$50,429.74

Service Code	APR-DRG 3833
Min. Negotiated Rate	$11,517.00
Max. Negotiated Rate	$50,429.74
Rate for Payer: Amida Care Medicaid	$22,413.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,413.22
Rate for Payer: Fidelis Qualified Health Plan	$26,895.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,413.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,413.22
Rate for Payer: Healthfirst Commercial	$20,977.00
Rate for Payer: Healthfirst Essential Plan	$50,429.74
Rate for Payer: Healthfirst QHP	$11,517.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,413.22
Rate for Payer: SOMOS Essential	$50,429.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,413.22

APR-DRG 3834: Cellulitis & other skin infections

Facility IP

$78,775.45

Service Code	APR-DRG 3834
Min. Negotiated Rate	$26,975.00
Max. Negotiated Rate	$78,775.45
Rate for Payer: Amida Care Medicaid	$35,011.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,011.31
Rate for Payer: Fidelis Qualified Health Plan	$42,013.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,011.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,011.31
Rate for Payer: Healthfirst Commercial	$49,738.00
Rate for Payer: Healthfirst Essential Plan	$78,775.45
Rate for Payer: Healthfirst QHP	$26,975.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,011.31
Rate for Payer: SOMOS Essential	$78,775.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,011.31

APR-DRG 3841: Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility IP

$36,903.22

Service Code	APR-DRG 3841
Min. Negotiated Rate	$4,944.00
Max. Negotiated Rate	$36,903.22
Rate for Payer: Amida Care Medicaid	$16,401.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,401.43
Rate for Payer: Fidelis Qualified Health Plan	$19,681.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,401.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,401.43
Rate for Payer: Healthfirst Commercial	$8,588.00
Rate for Payer: Healthfirst Essential Plan	$36,903.22
Rate for Payer: Healthfirst QHP	$4,944.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,401.43
Rate for Payer: SOMOS Essential	$36,903.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,401.43

APR-DRG 3842: Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility IP

$39,829.77

Service Code	APR-DRG 3842
Min. Negotiated Rate	$6,515.00
Max. Negotiated Rate	$39,829.77
Rate for Payer: Amida Care Medicaid	$17,702.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,702.12
Rate for Payer: Fidelis Qualified Health Plan	$21,242.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,702.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,702.12
Rate for Payer: Healthfirst Commercial	$11,307.00
Rate for Payer: Healthfirst Essential Plan	$39,829.77
Rate for Payer: Healthfirst QHP	$6,515.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,702.12
Rate for Payer: SOMOS Essential	$39,829.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,702.12

APR-DRG 3843: Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility IP

$47,462.74

Service Code	APR-DRG 3843
Min. Negotiated Rate	$10,183.00
Max. Negotiated Rate	$47,462.74
Rate for Payer: Amida Care Medicaid	$21,094.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,094.55
Rate for Payer: Fidelis Qualified Health Plan	$25,313.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,094.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,094.55
Rate for Payer: Healthfirst Commercial	$17,440.00
Rate for Payer: Healthfirst Essential Plan	$47,462.74
Rate for Payer: Healthfirst QHP	$10,183.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,094.55
Rate for Payer: SOMOS Essential	$47,462.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,094.55

APR-DRG 3844: Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility IP

$61,998.77

Service Code	APR-DRG 3844
Min. Negotiated Rate	$23,269.00
Max. Negotiated Rate	$61,998.77
Rate for Payer: Amida Care Medicaid	$27,555.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,555.01
Rate for Payer: Fidelis Qualified Health Plan	$33,066.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,555.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,555.01
Rate for Payer: Healthfirst Commercial	$31,873.00
Rate for Payer: Healthfirst Essential Plan	$61,998.77
Rate for Payer: Healthfirst QHP	$23,269.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,555.01
Rate for Payer: SOMOS Essential	$61,998.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,555.01

APR-DRG 3851: Other skin, subcutaneous tissue & breast disorders

Facility IP

$38,072.79

Service Code	APR-DRG 3851
Min. Negotiated Rate	$5,455.00
Max. Negotiated Rate	$38,072.79
Rate for Payer: Amida Care Medicaid	$16,921.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,921.24
Rate for Payer: Fidelis Qualified Health Plan	$20,305.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,921.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,921.24
Rate for Payer: Healthfirst Commercial	$9,646.00
Rate for Payer: Healthfirst Essential Plan	$38,072.79
Rate for Payer: Healthfirst QHP	$5,455.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,921.24
Rate for Payer: SOMOS Essential	$38,072.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,921.24

APR-DRG 3852: Other skin, subcutaneous tissue & breast disorders

Facility IP

$41,176.98

Service Code	APR-DRG 3852
Min. Negotiated Rate	$6,931.00
Max. Negotiated Rate	$41,176.98
Rate for Payer: Amida Care Medicaid	$18,300.88
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,300.88
Rate for Payer: Fidelis Qualified Health Plan	$21,961.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,300.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,300.88
Rate for Payer: Healthfirst Commercial	$12,106.00
Rate for Payer: Healthfirst Essential Plan	$41,176.98
Rate for Payer: Healthfirst QHP	$6,931.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,300.88
Rate for Payer: SOMOS Essential	$41,176.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,300.88

APR-DRG 3853: Other skin, subcutaneous tissue & breast disorders

Facility IP

$48,690.34

Service Code	APR-DRG 3853
Min. Negotiated Rate	$9,570.00
Max. Negotiated Rate	$48,690.34
Rate for Payer: Amida Care Medicaid	$21,640.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,640.15
Rate for Payer: Fidelis Qualified Health Plan	$25,968.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,640.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,640.15
Rate for Payer: Healthfirst Commercial	$16,966.00
Rate for Payer: Healthfirst Essential Plan	$48,690.34
Rate for Payer: Healthfirst QHP	$9,570.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,640.15
Rate for Payer: SOMOS Essential	$48,690.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,640.15

APR-DRG 3854: Other skin, subcutaneous tissue & breast disorders

Facility IP

$80,553.56

Service Code	APR-DRG 3854
Min. Negotiated Rate	$21,917.00
Max. Negotiated Rate	$80,553.56
Rate for Payer: Amida Care Medicaid	$35,801.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,801.58
Rate for Payer: Fidelis Qualified Health Plan	$42,961.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,801.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,801.58
Rate for Payer: Healthfirst Commercial	$37,366.00
Rate for Payer: Healthfirst Essential Plan	$80,553.56
Rate for Payer: Healthfirst QHP	$21,917.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,801.58
Rate for Payer: SOMOS Essential	$80,553.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,801.58

APR-DRG 4011: Pituitary & adrenal procedures

Facility IP

$51,400.58

Service Code	APR-DRG 4011
Min. Negotiated Rate	$14,650.00
Max. Negotiated Rate	$51,400.58
Rate for Payer: Amida Care Medicaid	$22,844.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,844.70
Rate for Payer: Fidelis Qualified Health Plan	$27,413.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,844.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,844.70
Rate for Payer: Healthfirst Commercial	$23,870.00
Rate for Payer: Healthfirst Essential Plan	$51,400.58
Rate for Payer: Healthfirst QHP	$14,650.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,844.70
Rate for Payer: SOMOS Essential	$51,400.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,844.70

APR-DRG 4012: Pituitary & adrenal procedures

Facility IP

$59,415.19

Service Code	APR-DRG 4012
Min. Negotiated Rate	$20,601.00
Max. Negotiated Rate	$59,415.19
Rate for Payer: Amida Care Medicaid	$26,406.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,406.75
Rate for Payer: Fidelis Qualified Health Plan	$31,688.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,406.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,406.75
Rate for Payer: Healthfirst Commercial	$33,967.00
Rate for Payer: Healthfirst Essential Plan	$59,415.19
Rate for Payer: Healthfirst QHP	$20,601.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,406.75
Rate for Payer: SOMOS Essential	$59,415.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,406.75

APR-DRG 4013: Pituitary & adrenal procedures

Facility IP

$84,144.92

Service Code	APR-DRG 4013
Min. Negotiated Rate	$37,397.74
Max. Negotiated Rate	$84,144.92
Rate for Payer: Amida Care Medicaid	$37,397.74
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,397.74
Rate for Payer: Fidelis Qualified Health Plan	$44,877.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,397.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,397.74
Rate for Payer: Healthfirst Commercial	$61,736.00
Rate for Payer: Healthfirst Essential Plan	$84,144.92
Rate for Payer: Healthfirst QHP	$39,928.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,397.74
Rate for Payer: SOMOS Essential	$84,144.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,397.74

APR-DRG 4014: Pituitary & adrenal procedures

Facility IP

$156,232.00

Service Code	APR-DRG 4014
Min. Negotiated Rate	$67,795.13
Max. Negotiated Rate	$156,232.00
Rate for Payer: Amida Care Medicaid	$67,795.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$67,795.13
Rate for Payer: Fidelis Qualified Health Plan	$81,354.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$67,795.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$67,795.13
Rate for Payer: Healthfirst Commercial	$156,232.00
Rate for Payer: Healthfirst Essential Plan	$152,539.04
Rate for Payer: Healthfirst QHP	$81,621.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$67,795.13
Rate for Payer: SOMOS Essential	$152,539.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$67,795.13

APR-DRG 4031: Procedures for obesity

Facility IP

$49,692.82

Service Code	APR-DRG 4031
Min. Negotiated Rate	$14,760.00
Max. Negotiated Rate	$49,692.82
Rate for Payer: Amida Care Medicaid	$22,085.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,085.70
Rate for Payer: Fidelis Qualified Health Plan	$26,502.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,085.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,085.70
Rate for Payer: Healthfirst Commercial	$23,755.00
Rate for Payer: Healthfirst Essential Plan	$49,692.82
Rate for Payer: Healthfirst QHP	$14,760.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,085.70
Rate for Payer: SOMOS Essential	$49,692.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,085.70

APR-DRG 4032: Procedures for obesity

Facility IP

$52,183.22

Service Code	APR-DRG 4032
Min. Negotiated Rate	$15,640.00
Max. Negotiated Rate	$52,183.22
Rate for Payer: Amida Care Medicaid	$23,192.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,192.54
Rate for Payer: Fidelis Qualified Health Plan	$27,831.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,192.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,192.54
Rate for Payer: Healthfirst Commercial	$26,278.00
Rate for Payer: Healthfirst Essential Plan	$52,183.22
Rate for Payer: Healthfirst QHP	$15,640.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,192.54
Rate for Payer: SOMOS Essential	$52,183.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,192.54

APR-DRG 4033: Procedures for obesity

Facility IP

$66,587.33

Service Code	APR-DRG 4033
Min. Negotiated Rate	$22,982.00
Max. Negotiated Rate	$66,587.33
Rate for Payer: Amida Care Medicaid	$29,594.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,594.37
Rate for Payer: Fidelis Qualified Health Plan	$35,513.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,594.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,594.37
Rate for Payer: Healthfirst Commercial	$45,579.00
Rate for Payer: Healthfirst Essential Plan	$66,587.33
Rate for Payer: Healthfirst QHP	$22,982.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,594.37
Rate for Payer: SOMOS Essential	$66,587.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,594.37

APR-DRG 4034: Procedures for obesity

Facility IP

$145,310.58

Service Code	APR-DRG 4034
Min. Negotiated Rate	$64,582.48
Max. Negotiated Rate	$145,310.58
Rate for Payer: Amida Care Medicaid	$64,582.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$64,582.48
Rate for Payer: Fidelis Qualified Health Plan	$77,498.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$64,582.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$64,582.48
Rate for Payer: Healthfirst Commercial	$124,862.00
Rate for Payer: Healthfirst Essential Plan	$145,310.58
Rate for Payer: Healthfirst QHP	$77,206.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$64,582.48
Rate for Payer: SOMOS Essential	$145,310.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$64,582.48

Price Transparency.

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