St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 4041: Thyroid, parathyroid & thyroglossal procedures

Facility IP

$41,398.58

Service Code	APR-DRG 4041
Min. Negotiated Rate	$7,470.00
Max. Negotiated Rate	$41,398.58
Rate for Payer: Amida Care Medicaid	$18,399.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,399.37
Rate for Payer: Fidelis Qualified Health Plan	$22,079.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,399.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,399.37
Rate for Payer: Healthfirst Commercial	$12,566.00
Rate for Payer: Healthfirst Essential Plan	$41,398.58
Rate for Payer: Healthfirst QHP	$7,470.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,399.37
Rate for Payer: SOMOS Essential	$41,398.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,399.37

APR-DRG 4042: Thyroid, parathyroid & thyroglossal procedures

Facility IP

$44,912.56

Service Code	APR-DRG 4042
Min. Negotiated Rate	$9,274.00
Max. Negotiated Rate	$44,912.56
Rate for Payer: Amida Care Medicaid	$19,961.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,961.14
Rate for Payer: Fidelis Qualified Health Plan	$23,953.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,961.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,961.14
Rate for Payer: Healthfirst Commercial	$15,353.00
Rate for Payer: Healthfirst Essential Plan	$44,912.56
Rate for Payer: Healthfirst QHP	$9,274.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,961.14
Rate for Payer: SOMOS Essential	$44,912.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,961.14

APR-DRG 4043: Thyroid, parathyroid & thyroglossal procedures

Facility IP

$68,854.36

Service Code	APR-DRG 4043
Min. Negotiated Rate	$22,762.00
Max. Negotiated Rate	$68,854.36
Rate for Payer: Amida Care Medicaid	$30,601.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,601.94
Rate for Payer: Fidelis Qualified Health Plan	$36,722.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,601.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,601.94
Rate for Payer: Healthfirst Commercial	$43,447.00
Rate for Payer: Healthfirst Essential Plan	$68,854.36
Rate for Payer: Healthfirst QHP	$22,762.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,601.94
Rate for Payer: SOMOS Essential	$68,854.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,601.94

APR-DRG 4044: Thyroid, parathyroid & thyroglossal procedures

Facility IP

$76,543.60

Service Code	APR-DRG 4044
Min. Negotiated Rate	$25,866.00
Max. Negotiated Rate	$76,543.60
Rate for Payer: Amida Care Medicaid	$34,019.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,019.38
Rate for Payer: Fidelis Qualified Health Plan	$40,823.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,019.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,019.38
Rate for Payer: Healthfirst Commercial	$48,730.00
Rate for Payer: Healthfirst Essential Plan	$76,543.60
Rate for Payer: Healthfirst QHP	$25,866.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,019.38
Rate for Payer: SOMOS Essential	$76,543.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,019.38

APR-DRG 4051: Other procedures for endocrine, nutritional & metabolic disorders

Facility IP

$50,146.58

Service Code	APR-DRG 4051
Min. Negotiated Rate	$12,645.00
Max. Negotiated Rate	$50,146.58
Rate for Payer: Amida Care Medicaid	$22,287.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,287.37
Rate for Payer: Fidelis Qualified Health Plan	$26,744.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,287.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,287.37
Rate for Payer: Healthfirst Commercial	$20,232.00
Rate for Payer: Healthfirst Essential Plan	$50,146.58
Rate for Payer: Healthfirst QHP	$12,645.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,287.37
Rate for Payer: SOMOS Essential	$50,146.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,287.37

APR-DRG 4052: Other procedures for endocrine, nutritional & metabolic disorders

Facility IP

$59,429.25

Service Code	APR-DRG 4052
Min. Negotiated Rate	$19,712.00
Max. Negotiated Rate	$59,429.25
Rate for Payer: Amida Care Medicaid	$26,413.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,413.00
Rate for Payer: Fidelis Qualified Health Plan	$31,695.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,413.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,413.00
Rate for Payer: Healthfirst Commercial	$32,417.00
Rate for Payer: Healthfirst Essential Plan	$59,429.25
Rate for Payer: Healthfirst QHP	$19,712.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,413.00
Rate for Payer: SOMOS Essential	$59,429.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,413.00

APR-DRG 4053: Other procedures for endocrine, nutritional & metabolic disorders

Facility IP

$81,439.96

Service Code	APR-DRG 4053
Min. Negotiated Rate	$31,654.00
Max. Negotiated Rate	$81,439.96
Rate for Payer: Amida Care Medicaid	$36,195.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,195.54
Rate for Payer: Fidelis Qualified Health Plan	$43,434.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,195.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,195.54
Rate for Payer: Healthfirst Commercial	$55,216.00
Rate for Payer: Healthfirst Essential Plan	$81,439.96
Rate for Payer: Healthfirst QHP	$31,654.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,195.54
Rate for Payer: SOMOS Essential	$81,439.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,195.54

APR-DRG 4054: Other procedures for endocrine, nutritional & metabolic disorders

Facility IP

$177,168.51

Service Code	APR-DRG 4054
Min. Negotiated Rate	$78,741.56
Max. Negotiated Rate	$177,168.51
Rate for Payer: Amida Care Medicaid	$78,741.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$78,741.56
Rate for Payer: Fidelis Qualified Health Plan	$94,489.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$78,741.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$78,741.56
Rate for Payer: Healthfirst Commercial	$138,095.00
Rate for Payer: Healthfirst Essential Plan	$177,168.51
Rate for Payer: Healthfirst QHP	$89,909.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$78,741.56
Rate for Payer: SOMOS Essential	$177,168.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$78,741.56

APR-DRG 4201: Diabetes

Facility IP

$37,655.98

Service Code	APR-DRG 4201
Min. Negotiated Rate	$5,458.00
Max. Negotiated Rate	$37,655.98
Rate for Payer: Amida Care Medicaid	$16,735.99
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,735.99
Rate for Payer: Fidelis Qualified Health Plan	$20,083.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,735.99
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,735.99
Rate for Payer: Healthfirst Commercial	$9,360.00
Rate for Payer: Healthfirst Essential Plan	$37,655.98
Rate for Payer: Healthfirst QHP	$5,458.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,735.99
Rate for Payer: SOMOS Essential	$37,655.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,735.99

APR-DRG 4202: Diabetes

Facility IP

$40,742.57

Service Code	APR-DRG 4202
Min. Negotiated Rate	$7,028.00
Max. Negotiated Rate	$40,742.57
Rate for Payer: Amida Care Medicaid	$18,107.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,107.81
Rate for Payer: Fidelis Qualified Health Plan	$21,729.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,107.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,107.81
Rate for Payer: Healthfirst Commercial	$11,924.00
Rate for Payer: Healthfirst Essential Plan	$40,742.57
Rate for Payer: Healthfirst QHP	$7,028.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,107.81
Rate for Payer: SOMOS Essential	$40,742.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,107.81

APR-DRG 4203: Diabetes

Facility IP

$46,831.34

Service Code	APR-DRG 4203
Min. Negotiated Rate	$9,693.00
Max. Negotiated Rate	$46,831.34
Rate for Payer: Amida Care Medicaid	$20,813.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,813.93
Rate for Payer: Fidelis Qualified Health Plan	$24,976.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,813.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,813.93
Rate for Payer: Healthfirst Commercial	$17,116.00
Rate for Payer: Healthfirst Essential Plan	$46,831.34
Rate for Payer: Healthfirst QHP	$9,693.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,813.93
Rate for Payer: SOMOS Essential	$46,831.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,813.93

APR-DRG 4204: Diabetes

Facility IP

$74,315.27

Service Code	APR-DRG 4204
Min. Negotiated Rate	$21,056.00
Max. Negotiated Rate	$74,315.27
Rate for Payer: Amida Care Medicaid	$33,029.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,029.01
Rate for Payer: Fidelis Qualified Health Plan	$39,634.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,029.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,029.01
Rate for Payer: Healthfirst Commercial	$43,948.00
Rate for Payer: Healthfirst Essential Plan	$74,315.27
Rate for Payer: Healthfirst QHP	$21,056.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,029.01
Rate for Payer: SOMOS Essential	$74,315.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,029.01

APR-DRG 4211: Malnutrition, failure to thrive & other nutritional disorders

Facility IP

$40,635.29

Service Code	APR-DRG 4211
Min. Negotiated Rate	$6,336.00
Max. Negotiated Rate	$40,635.29
Rate for Payer: Amida Care Medicaid	$18,060.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,060.13
Rate for Payer: Fidelis Qualified Health Plan	$21,672.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,060.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,060.13
Rate for Payer: Healthfirst Commercial	$11,872.00
Rate for Payer: Healthfirst Essential Plan	$40,635.29
Rate for Payer: Healthfirst QHP	$6,336.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,060.13
Rate for Payer: SOMOS Essential	$40,635.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,060.13

APR-DRG 4212: Malnutrition, failure to thrive & other nutritional disorders

Facility IP

$45,705.76

Service Code	APR-DRG 4212
Min. Negotiated Rate	$8,702.00
Max. Negotiated Rate	$45,705.76
Rate for Payer: Amida Care Medicaid	$20,313.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,313.67
Rate for Payer: Fidelis Qualified Health Plan	$24,376.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,313.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,313.67
Rate for Payer: Healthfirst Commercial	$15,691.00
Rate for Payer: Healthfirst Essential Plan	$45,705.76
Rate for Payer: Healthfirst QHP	$8,702.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,313.67
Rate for Payer: SOMOS Essential	$45,705.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,313.67

APR-DRG 4213: Malnutrition, failure to thrive & other nutritional disorders

Facility IP

$54,047.48

Service Code	APR-DRG 4213
Min. Negotiated Rate	$13,380.00
Max. Negotiated Rate	$54,047.48
Rate for Payer: Amida Care Medicaid	$24,021.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,021.10
Rate for Payer: Fidelis Qualified Health Plan	$28,825.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,021.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,021.10
Rate for Payer: Healthfirst Commercial	$22,425.00
Rate for Payer: Healthfirst Essential Plan	$54,047.48
Rate for Payer: Healthfirst QHP	$13,380.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,021.10
Rate for Payer: SOMOS Essential	$54,047.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,021.10

APR-DRG 4214: Malnutrition, failure to thrive & other nutritional disorders

Facility IP

$85,945.86

Service Code	APR-DRG 4214
Min. Negotiated Rate	$29,561.00
Max. Negotiated Rate	$85,945.86
Rate for Payer: Amida Care Medicaid	$38,198.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$38,198.16
Rate for Payer: Fidelis Qualified Health Plan	$45,837.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$38,198.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38,198.16
Rate for Payer: Healthfirst Commercial	$52,245.00
Rate for Payer: Healthfirst Essential Plan	$85,945.86
Rate for Payer: Healthfirst QHP	$29,561.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,198.16
Rate for Payer: SOMOS Essential	$85,945.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$38,198.16

APR-DRG 4221: Hypovolemia & related electrolyte disorders

Facility IP

$36,292.95

Service Code	APR-DRG 4221
Min. Negotiated Rate	$4,593.00
Max. Negotiated Rate	$36,292.95
Rate for Payer: Amida Care Medicaid	$16,130.20
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,130.20
Rate for Payer: Fidelis Qualified Health Plan	$19,356.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,130.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,130.20
Rate for Payer: Healthfirst Commercial	$8,138.00
Rate for Payer: Healthfirst Essential Plan	$36,292.95
Rate for Payer: Healthfirst QHP	$4,593.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,130.20
Rate for Payer: SOMOS Essential	$36,292.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,130.20

APR-DRG 4222: Hypovolemia & related electrolyte disorders

Facility IP

$38,894.13

Service Code	APR-DRG 4222
Min. Negotiated Rate	$6,327.00
Max. Negotiated Rate	$38,894.13
Rate for Payer: Amida Care Medicaid	$17,286.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,286.28
Rate for Payer: Fidelis Qualified Health Plan	$20,743.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,286.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,286.28
Rate for Payer: Healthfirst Commercial	$10,591.00
Rate for Payer: Healthfirst Essential Plan	$38,894.13
Rate for Payer: Healthfirst QHP	$6,327.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,286.28
Rate for Payer: SOMOS Essential	$38,894.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,286.28

APR-DRG 4223: Hypovolemia & related electrolyte disorders

Facility IP

$45,507.02

Service Code	APR-DRG 4223
Min. Negotiated Rate	$9,735.00
Max. Negotiated Rate	$45,507.02
Rate for Payer: Amida Care Medicaid	$20,225.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,225.34
Rate for Payer: Fidelis Qualified Health Plan	$24,270.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,225.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,225.34
Rate for Payer: Healthfirst Commercial	$17,125.00
Rate for Payer: Healthfirst Essential Plan	$45,507.02
Rate for Payer: Healthfirst QHP	$9,735.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,225.34
Rate for Payer: SOMOS Essential	$45,507.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,225.34

APR-DRG 4224: Hypovolemia & related electrolyte disorders

Facility IP

$69,571.94

Service Code	APR-DRG 4224
Min. Negotiated Rate	$21,720.00
Max. Negotiated Rate	$69,571.94
Rate for Payer: Amida Care Medicaid	$30,920.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,920.86
Rate for Payer: Fidelis Qualified Health Plan	$37,105.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,920.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,920.86
Rate for Payer: Healthfirst Commercial	$42,388.00
Rate for Payer: Healthfirst Essential Plan	$69,571.94
Rate for Payer: Healthfirst QHP	$21,720.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,920.86
Rate for Payer: SOMOS Essential	$69,571.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,920.86

APR-DRG 4231: Inborn errors of metabolism

Facility IP

$40,448.86

Service Code	APR-DRG 4231
Min. Negotiated Rate	$5,546.00
Max. Negotiated Rate	$40,448.86
Rate for Payer: Amida Care Medicaid	$17,977.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,977.27
Rate for Payer: Fidelis Qualified Health Plan	$21,572.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,977.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,977.27
Rate for Payer: Healthfirst Commercial	$9,950.00
Rate for Payer: Healthfirst Essential Plan	$40,448.86
Rate for Payer: Healthfirst QHP	$5,546.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,977.27
Rate for Payer: SOMOS Essential	$40,448.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,977.27

APR-DRG 4232: Inborn errors of metabolism

Facility IP

$47,429.32

Service Code	APR-DRG 4232
Min. Negotiated Rate	$7,571.00
Max. Negotiated Rate	$47,429.32
Rate for Payer: Amida Care Medicaid	$21,079.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,079.70
Rate for Payer: Fidelis Qualified Health Plan	$25,295.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,079.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,079.70
Rate for Payer: Healthfirst Commercial	$15,189.00
Rate for Payer: Healthfirst Essential Plan	$47,429.32
Rate for Payer: Healthfirst QHP	$7,571.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,079.70
Rate for Payer: SOMOS Essential	$47,429.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,079.70

APR-DRG 4233: Inborn errors of metabolism

Facility IP

$57,779.55

Service Code	APR-DRG 4233
Min. Negotiated Rate	$15,363.00
Max. Negotiated Rate	$57,779.55
Rate for Payer: Amida Care Medicaid	$25,679.80
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,679.80
Rate for Payer: Fidelis Qualified Health Plan	$30,815.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,679.80
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,679.80
Rate for Payer: Healthfirst Commercial	$27,115.00
Rate for Payer: Healthfirst Essential Plan	$57,779.55
Rate for Payer: Healthfirst QHP	$15,363.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,679.80
Rate for Payer: SOMOS Essential	$57,779.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,679.80

APR-DRG 4234: Inborn errors of metabolism

Facility IP

$125,289.02

Service Code	APR-DRG 4234
Min. Negotiated Rate	$35,549.00
Max. Negotiated Rate	$125,289.02
Rate for Payer: Amida Care Medicaid	$55,684.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$55,684.01
Rate for Payer: Fidelis Qualified Health Plan	$66,820.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$55,684.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$55,684.01
Rate for Payer: Healthfirst Commercial	$77,092.00
Rate for Payer: Healthfirst Essential Plan	$125,289.02
Rate for Payer: Healthfirst QHP	$35,549.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55,684.01
Rate for Payer: SOMOS Essential	$125,289.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$55,684.01

APR-DRG 4241: Other endocrine disorders

Facility IP

$38,417.51

Service Code	APR-DRG 4241
Min. Negotiated Rate	$5,801.00
Max. Negotiated Rate	$38,417.51
Rate for Payer: Amida Care Medicaid	$17,074.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,074.45
Rate for Payer: Fidelis Qualified Health Plan	$20,489.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,074.45
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,074.45
Rate for Payer: Healthfirst Commercial	$10,109.00
Rate for Payer: Healthfirst Essential Plan	$38,417.51
Rate for Payer: Healthfirst QHP	$5,801.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,074.45
Rate for Payer: SOMOS Essential	$38,417.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,074.45

Price Transparency.

All Charges