St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 1904: Acute myocardial infarction

Facility

$79,120.17

Service Code	APR-DRG 1904
Min. Negotiated Rate	$24,966.00
Max. Negotiated Rate	$79,120.17
Rate for Payer: Affinity Essential Plan 1&2	$79,120.17
Rate for Payer: Affinity Essential Plan 3&4	$79,120.17
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,164.52
Rate for Payer: Amida Care Medicaid	$35,164.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,164.52
Rate for Payer: Fidelis Qualified Health Plan	$42,197.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,164.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,164.52
Rate for Payer: Healthfirst Commercial	$45,975.00
Rate for Payer: Healthfirst Essential Plan	$79,120.17
Rate for Payer: Healthfirst QHP	$24,966.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,164.52
Rate for Payer: SOMOS Essential	$79,120.17
Rate for Payer: United Healthcare Essential Plan 1&2	$79,120.17
Rate for Payer: United Healthcare Essential Plan 3&4	$79,120.17
Rate for Payer: United Healthcare Medicaid	$35,164.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,164.52

APR-DRG 1911: Cardiac catheterization for coronary artery disease

Facility

$42,253.34

Service Code	APR-DRG 1911
Min. Negotiated Rate	$9,497.00
Max. Negotiated Rate	$42,253.34
Rate for Payer: Affinity Essential Plan 1&2	$42,253.34
Rate for Payer: Affinity Essential Plan 3&4	$42,253.34
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,779.26
Rate for Payer: Amida Care Medicaid	$18,779.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,779.26
Rate for Payer: Fidelis Qualified Health Plan	$22,535.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,779.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,779.26
Rate for Payer: Healthfirst Commercial	$16,705.00
Rate for Payer: Healthfirst Essential Plan	$42,253.34
Rate for Payer: Healthfirst QHP	$9,497.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,779.26
Rate for Payer: SOMOS Essential	$42,253.34
Rate for Payer: United Healthcare Essential Plan 1&2	$42,253.34
Rate for Payer: United Healthcare Essential Plan 3&4	$42,253.34
Rate for Payer: United Healthcare Medicaid	$18,779.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,779.26

APR-DRG 1912: Cardiac catheterization for coronary artery disease

Facility

$45,053.26

Service Code	APR-DRG 1912
Min. Negotiated Rate	$11,373.00
Max. Negotiated Rate	$45,053.26
Rate for Payer: Affinity Essential Plan 1&2	$45,053.26
Rate for Payer: Affinity Essential Plan 3&4	$45,053.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,023.67
Rate for Payer: Amida Care Medicaid	$20,023.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,023.67
Rate for Payer: Fidelis Qualified Health Plan	$24,028.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,023.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,023.67
Rate for Payer: Healthfirst Commercial	$20,456.00
Rate for Payer: Healthfirst Essential Plan	$45,053.26
Rate for Payer: Healthfirst QHP	$11,373.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,023.67
Rate for Payer: SOMOS Essential	$45,053.26
Rate for Payer: United Healthcare Essential Plan 1&2	$45,053.26
Rate for Payer: United Healthcare Essential Plan 3&4	$45,053.26
Rate for Payer: United Healthcare Medicaid	$20,023.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,023.67

APR-DRG 1913: Cardiac catheterization for coronary artery disease

Facility

$54,735.14

Service Code	APR-DRG 1913
Min. Negotiated Rate	$15,119.00
Max. Negotiated Rate	$54,735.14
Rate for Payer: Affinity Essential Plan 1&2	$54,735.14
Rate for Payer: Affinity Essential Plan 3&4	$54,735.14
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,326.73
Rate for Payer: Amida Care Medicaid	$24,326.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,326.73
Rate for Payer: Fidelis Qualified Health Plan	$29,192.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,326.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,326.73
Rate for Payer: Healthfirst Commercial	$28,946.00
Rate for Payer: Healthfirst Essential Plan	$54,735.14
Rate for Payer: Healthfirst QHP	$15,119.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,326.73
Rate for Payer: SOMOS Essential	$54,735.14
Rate for Payer: United Healthcare Essential Plan 1&2	$54,735.14
Rate for Payer: United Healthcare Essential Plan 3&4	$54,735.14
Rate for Payer: United Healthcare Medicaid	$24,326.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,326.73

APR-DRG 1914: Cardiac catheterization for coronary artery disease

Facility

$80,242.00

Service Code	APR-DRG 1914
Min. Negotiated Rate	$33,869.30
Max. Negotiated Rate	$80,242.00
Rate for Payer: Affinity Essential Plan 1&2	$76,205.92
Rate for Payer: Affinity Essential Plan 3&4	$76,205.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,869.30
Rate for Payer: Amida Care Medicaid	$33,869.30
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,869.30
Rate for Payer: Fidelis Qualified Health Plan	$40,643.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,869.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,869.30
Rate for Payer: Healthfirst Commercial	$80,242.00
Rate for Payer: Healthfirst Essential Plan	$76,205.92
Rate for Payer: Healthfirst QHP	$33,900.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,869.30
Rate for Payer: SOMOS Essential	$76,205.92
Rate for Payer: United Healthcare Essential Plan 1&2	$76,205.92
Rate for Payer: United Healthcare Essential Plan 3&4	$76,205.92
Rate for Payer: United Healthcare Medicaid	$33,869.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,869.30

APR-DRG 1921: Cardiac catheterization for other non-coronary conditions

Facility

$42,272.68

Service Code	APR-DRG 1921
Min. Negotiated Rate	$7,646.00
Max. Negotiated Rate	$42,272.68
Rate for Payer: Affinity Essential Plan 1&2	$42,272.68
Rate for Payer: Affinity Essential Plan 3&4	$42,272.68
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,787.86
Rate for Payer: Amida Care Medicaid	$18,787.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,787.86
Rate for Payer: Fidelis Qualified Health Plan	$22,545.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,787.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,787.86
Rate for Payer: Healthfirst Commercial	$13,491.00
Rate for Payer: Healthfirst Essential Plan	$42,272.68
Rate for Payer: Healthfirst QHP	$7,646.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,787.86
Rate for Payer: SOMOS Essential	$42,272.68
Rate for Payer: United Healthcare Essential Plan 1&2	$42,272.68
Rate for Payer: United Healthcare Essential Plan 3&4	$42,272.68
Rate for Payer: United Healthcare Medicaid	$18,787.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,787.86

APR-DRG 1922: Cardiac catheterization for other non-coronary conditions

Facility

$47,571.77

Service Code	APR-DRG 1922
Min. Negotiated Rate	$8,834.00
Max. Negotiated Rate	$47,571.77
Rate for Payer: Affinity Essential Plan 1&2	$47,571.77
Rate for Payer: Affinity Essential Plan 3&4	$47,571.77
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,143.01
Rate for Payer: Amida Care Medicaid	$21,143.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,143.01
Rate for Payer: Fidelis Qualified Health Plan	$25,371.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,143.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,143.01
Rate for Payer: Healthfirst Commercial	$16,183.00
Rate for Payer: Healthfirst Essential Plan	$47,571.77
Rate for Payer: Healthfirst QHP	$8,834.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,143.01
Rate for Payer: SOMOS Essential	$47,571.77
Rate for Payer: United Healthcare Essential Plan 1&2	$47,571.77
Rate for Payer: United Healthcare Essential Plan 3&4	$47,571.77
Rate for Payer: United Healthcare Medicaid	$21,143.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,143.01

APR-DRG 1923: Cardiac catheterization for other non-coronary conditions

Facility

$61,650.54

Service Code	APR-DRG 1923
Min. Negotiated Rate	$12,172.00
Max. Negotiated Rate	$61,650.54
Rate for Payer: Affinity Essential Plan 1&2	$61,650.54
Rate for Payer: Affinity Essential Plan 3&4	$61,650.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,400.24
Rate for Payer: Amida Care Medicaid	$27,400.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,400.24
Rate for Payer: Fidelis Qualified Health Plan	$32,880.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,400.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,400.24
Rate for Payer: Healthfirst Commercial	$22,228.00
Rate for Payer: Healthfirst Essential Plan	$61,650.54
Rate for Payer: Healthfirst QHP	$12,172.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,400.24
Rate for Payer: SOMOS Essential	$61,650.54
Rate for Payer: United Healthcare Essential Plan 1&2	$61,650.54
Rate for Payer: United Healthcare Essential Plan 3&4	$61,650.54
Rate for Payer: United Healthcare Medicaid	$27,400.24
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,400.24

APR-DRG 1924: Cardiac catheterization for other non-coronary conditions

Facility

$102,055.97

Service Code	APR-DRG 1924
Min. Negotiated Rate	$21,665.00
Max. Negotiated Rate	$102,055.97
Rate for Payer: Affinity Essential Plan 1&2	$102,055.97
Rate for Payer: Affinity Essential Plan 3&4	$102,055.97
Rate for Payer: Affinity Medicaid/CHP/HARP	$45,358.21
Rate for Payer: Amida Care Medicaid	$45,358.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,358.21
Rate for Payer: Fidelis Qualified Health Plan	$54,429.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,358.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,358.21
Rate for Payer: Healthfirst Commercial	$58,081.00
Rate for Payer: Healthfirst Essential Plan	$102,055.97
Rate for Payer: Healthfirst QHP	$21,665.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,358.21
Rate for Payer: SOMOS Essential	$102,055.97
Rate for Payer: United Healthcare Essential Plan 1&2	$102,055.97
Rate for Payer: United Healthcare Essential Plan 3&4	$102,055.97
Rate for Payer: United Healthcare Medicaid	$45,358.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,358.21

APR-DRG 1931: Acute & subacute endocarditis

Facility

$47,789.86

Service Code	APR-DRG 1931
Min. Negotiated Rate	$10,225.00
Max. Negotiated Rate	$47,789.86
Rate for Payer: Affinity Essential Plan 1&2	$47,789.86
Rate for Payer: Affinity Essential Plan 3&4	$47,789.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,239.94
Rate for Payer: Amida Care Medicaid	$21,239.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,239.94
Rate for Payer: Fidelis Qualified Health Plan	$25,487.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,239.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,239.94
Rate for Payer: Healthfirst Commercial	$17,672.00
Rate for Payer: Healthfirst Essential Plan	$47,789.86
Rate for Payer: Healthfirst QHP	$10,225.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,239.94
Rate for Payer: SOMOS Essential	$47,789.86
Rate for Payer: United Healthcare Essential Plan 1&2	$47,789.86
Rate for Payer: United Healthcare Essential Plan 3&4	$47,789.86
Rate for Payer: United Healthcare Medicaid	$21,239.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,239.94

APR-DRG 1932: Acute & subacute endocarditis

Facility

$53,880.41

Service Code	APR-DRG 1932
Min. Negotiated Rate	$13,507.00
Max. Negotiated Rate	$53,880.41
Rate for Payer: Affinity Essential Plan 1&2	$53,880.41
Rate for Payer: Affinity Essential Plan 3&4	$53,880.41
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,946.85
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	$24,076.00
Rate for Payer: Healthfirst Essential Plan	$53,880.41
Rate for Payer: Healthfirst QHP	$13,507.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,946.85
Rate for Payer: SOMOS Essential	$53,880.41
Rate for Payer: United Healthcare Essential Plan 1&2	$53,880.41
Rate for Payer: United Healthcare Essential Plan 3&4	$53,880.41
Rate for Payer: United Healthcare Medicaid	$23,946.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,946.85

APR-DRG 1933: Acute & subacute endocarditis

Facility

$67,512.44

Service Code	APR-DRG 1933
Min. Negotiated Rate	$24,164.00
Max. Negotiated Rate	$67,512.44
Rate for Payer: Affinity Essential Plan 1&2	$67,512.44
Rate for Payer: Affinity Essential Plan 3&4	$67,512.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$30,005.53
Rate for Payer: Amida Care Medicaid	$30,005.53
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,005.53
Rate for Payer: Fidelis Qualified Health Plan	$36,006.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,005.53
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,005.53
Rate for Payer: Healthfirst Commercial	$39,405.00
Rate for Payer: Healthfirst Essential Plan	$67,512.44
Rate for Payer: Healthfirst QHP	$24,164.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,005.53
Rate for Payer: SOMOS Essential	$67,512.44
Rate for Payer: United Healthcare Essential Plan 1&2	$67,512.44
Rate for Payer: United Healthcare Essential Plan 3&4	$67,512.44
Rate for Payer: United Healthcare Medicaid	$30,005.53
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,005.53

APR-DRG 1934: Acute & subacute endocarditis

Facility

$108,157.07

Service Code	APR-DRG 1934
Min. Negotiated Rate	$41,208.00
Max. Negotiated Rate	$108,157.07
Rate for Payer: Affinity Essential Plan 1&2	$108,157.07
Rate for Payer: Affinity Essential Plan 3&4	$108,157.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$48,069.81
Rate for Payer: Amida Care Medicaid	$48,069.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$48,069.81
Rate for Payer: Fidelis Qualified Health Plan	$57,683.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$48,069.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$48,069.81
Rate for Payer: Healthfirst Commercial	$70,632.00
Rate for Payer: Healthfirst Essential Plan	$108,157.07
Rate for Payer: Healthfirst QHP	$41,208.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48,069.81
Rate for Payer: SOMOS Essential	$108,157.07
Rate for Payer: United Healthcare Essential Plan 1&2	$108,157.07
Rate for Payer: United Healthcare Essential Plan 3&4	$108,157.07
Rate for Payer: United Healthcare Medicaid	$48,069.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48,069.81

APR-DRG 1941: Heart failure

Facility

$39,664.46

Service Code	APR-DRG 1941
Min. Negotiated Rate	$6,668.00
Max. Negotiated Rate	$39,664.46
Rate for Payer: Affinity Essential Plan 1&2	$39,664.46
Rate for Payer: Affinity Essential Plan 3&4	$39,664.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,628.65
Rate for Payer: Amida Care Medicaid	$17,628.65
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,628.65
Rate for Payer: Fidelis Qualified Health Plan	$21,154.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,628.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,628.65
Rate for Payer: Healthfirst Commercial	$11,296.00
Rate for Payer: Healthfirst Essential Plan	$39,664.46
Rate for Payer: Healthfirst QHP	$6,668.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,628.65
Rate for Payer: SOMOS Essential	$39,664.46
Rate for Payer: United Healthcare Essential Plan 1&2	$39,664.46
Rate for Payer: United Healthcare Essential Plan 3&4	$39,664.46
Rate for Payer: United Healthcare Medicaid	$17,628.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,628.65

APR-DRG 1942: Heart failure

Facility

$43,558.31

Service Code	APR-DRG 1942
Min. Negotiated Rate	$8,532.00
Max. Negotiated Rate	$43,558.31
Rate for Payer: Affinity Essential Plan 1&2	$43,558.31
Rate for Payer: Affinity Essential Plan 3&4	$43,558.31
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,359.25
Rate for Payer: Amida Care Medicaid	$19,359.25
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,359.25
Rate for Payer: Fidelis Qualified Health Plan	$23,231.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,359.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,359.25
Rate for Payer: Healthfirst Commercial	$14,579.00
Rate for Payer: Healthfirst Essential Plan	$43,558.31
Rate for Payer: Healthfirst QHP	$8,532.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,359.25
Rate for Payer: SOMOS Essential	$43,558.31
Rate for Payer: United Healthcare Essential Plan 1&2	$43,558.31
Rate for Payer: United Healthcare Essential Plan 3&4	$43,558.31
Rate for Payer: United Healthcare Medicaid	$19,359.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,359.25

APR-DRG 1943: Heart failure

Facility

$52,396.02

Service Code	APR-DRG 1943
Min. Negotiated Rate	$13,142.00
Max. Negotiated Rate	$52,396.02
Rate for Payer: Affinity Essential Plan 1&2	$52,396.02
Rate for Payer: Affinity Essential Plan 3&4	$52,396.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,287.12
Rate for Payer: Amida Care Medicaid	$23,287.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,287.12
Rate for Payer: Fidelis Qualified Health Plan	$27,944.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,287.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,287.12
Rate for Payer: Healthfirst Commercial	$22,769.00
Rate for Payer: Healthfirst Essential Plan	$52,396.02
Rate for Payer: Healthfirst QHP	$13,142.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,287.12
Rate for Payer: SOMOS Essential	$52,396.02
Rate for Payer: United Healthcare Essential Plan 1&2	$52,396.02
Rate for Payer: United Healthcare Essential Plan 3&4	$52,396.02
Rate for Payer: United Healthcare Medicaid	$23,287.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,287.12

APR-DRG 1944: Heart failure

Facility

$80,442.74

Service Code	APR-DRG 1944
Min. Negotiated Rate	$28,654.00
Max. Negotiated Rate	$80,442.74
Rate for Payer: Affinity Essential Plan 1&2	$80,442.74
Rate for Payer: Affinity Essential Plan 3&4	$80,442.74
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,752.33
Rate for Payer: Amida Care Medicaid	$35,752.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,752.33
Rate for Payer: Fidelis Qualified Health Plan	$42,902.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,752.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,752.33
Rate for Payer: Healthfirst Commercial	$47,507.00
Rate for Payer: Healthfirst Essential Plan	$80,442.74
Rate for Payer: Healthfirst QHP	$28,654.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,752.33
Rate for Payer: SOMOS Essential	$80,442.74
Rate for Payer: United Healthcare Essential Plan 1&2	$80,442.74
Rate for Payer: United Healthcare Essential Plan 3&4	$80,442.74
Rate for Payer: United Healthcare Medicaid	$35,752.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,752.33

APR-DRG 1961: Cardiac arrest and shock

Facility

$39,944.09

Service Code	APR-DRG 1961
Min. Negotiated Rate	$5,073.00
Max. Negotiated Rate	$39,944.09
Rate for Payer: Affinity Essential Plan 1&2	$39,944.09
Rate for Payer: Affinity Essential Plan 3&4	$39,944.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,752.93
Rate for Payer: Amida Care Medicaid	$17,752.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,752.93
Rate for Payer: Fidelis Qualified Health Plan	$21,303.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,752.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,752.93
Rate for Payer: Healthfirst Commercial	$8,280.00
Rate for Payer: Healthfirst Essential Plan	$39,944.09
Rate for Payer: Healthfirst QHP	$5,073.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,752.93
Rate for Payer: SOMOS Essential	$39,944.09
Rate for Payer: United Healthcare Essential Plan 1&2	$39,944.09
Rate for Payer: United Healthcare Essential Plan 3&4	$39,944.09
Rate for Payer: United Healthcare Medicaid	$17,752.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,752.93

APR-DRG 1962: Cardiac arrest and shock

Facility

$40,758.39

Service Code	APR-DRG 1962
Min. Negotiated Rate	$6,596.00
Max. Negotiated Rate	$40,758.39
Rate for Payer: Affinity Essential Plan 1&2	$40,758.39
Rate for Payer: Affinity Essential Plan 3&4	$40,758.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,114.84
Rate for Payer: Amida Care Medicaid	$18,114.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,114.84
Rate for Payer: Fidelis Qualified Health Plan	$21,737.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,114.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,114.84
Rate for Payer: Healthfirst Commercial	$11,482.00
Rate for Payer: Healthfirst Essential Plan	$40,758.39
Rate for Payer: Healthfirst QHP	$6,596.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,114.84
Rate for Payer: SOMOS Essential	$40,758.39
Rate for Payer: United Healthcare Essential Plan 1&2	$40,758.39
Rate for Payer: United Healthcare Essential Plan 3&4	$40,758.39
Rate for Payer: United Healthcare Medicaid	$18,114.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,114.84

APR-DRG 1963: Cardiac arrest and shock

Facility

$41,980.72

Service Code	APR-DRG 1963
Min. Negotiated Rate	$8,755.00
Max. Negotiated Rate	$41,980.72
Rate for Payer: Affinity Essential Plan 1&2	$41,980.72
Rate for Payer: Affinity Essential Plan 3&4	$41,980.72
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,658.10
Rate for Payer: Amida Care Medicaid	$18,658.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,658.10
Rate for Payer: Fidelis Qualified Health Plan	$22,389.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,658.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,658.10
Rate for Payer: Healthfirst Commercial	$14,231.00
Rate for Payer: Healthfirst Essential Plan	$41,980.72
Rate for Payer: Healthfirst QHP	$8,755.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,658.10
Rate for Payer: SOMOS Essential	$41,980.72
Rate for Payer: United Healthcare Essential Plan 1&2	$41,980.72
Rate for Payer: United Healthcare Essential Plan 3&4	$41,980.72
Rate for Payer: United Healthcare Medicaid	$18,658.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,658.10

APR-DRG 1964: Cardiac arrest and shock

Facility

$66,414.98

Service Code	APR-DRG 1964
Min. Negotiated Rate	$20,119.00
Max. Negotiated Rate	$66,414.98
Rate for Payer: Affinity Essential Plan 1&2	$66,414.98
Rate for Payer: Affinity Essential Plan 3&4	$66,414.98
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,517.77
Rate for Payer: Amida Care Medicaid	$29,517.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,517.77
Rate for Payer: Fidelis Qualified Health Plan	$35,421.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,517.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,517.77
Rate for Payer: Healthfirst Commercial	$31,618.00
Rate for Payer: Healthfirst Essential Plan	$66,414.98
Rate for Payer: Healthfirst QHP	$20,119.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,517.77
Rate for Payer: SOMOS Essential	$66,414.98
Rate for Payer: United Healthcare Essential Plan 1&2	$66,414.98
Rate for Payer: United Healthcare Essential Plan 3&4	$66,414.98
Rate for Payer: United Healthcare Medicaid	$29,517.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,517.77

APR-DRG 1971: Peripheral & other vascular disorders

Facility

$39,949.38

Service Code	APR-DRG 1971
Min. Negotiated Rate	$7,006.00
Max. Negotiated Rate	$39,949.38
Rate for Payer: Affinity Essential Plan 1&2	$39,949.38
Rate for Payer: Affinity Essential Plan 3&4	$39,949.38
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,755.28
Rate for Payer: Amida Care Medicaid	$17,755.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,755.28
Rate for Payer: Fidelis Qualified Health Plan	$21,306.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,755.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,755.28
Rate for Payer: Healthfirst Commercial	$11,587.00
Rate for Payer: Healthfirst Essential Plan	$39,949.38
Rate for Payer: Healthfirst QHP	$7,006.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,755.28
Rate for Payer: SOMOS Essential	$39,949.38
Rate for Payer: United Healthcare Essential Plan 1&2	$39,949.38
Rate for Payer: United Healthcare Essential Plan 3&4	$39,949.38
Rate for Payer: United Healthcare Medicaid	$17,755.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,755.28

APR-DRG 1972: Peripheral & other vascular disorders

Facility

$43,577.66

Service Code	APR-DRG 1972
Min. Negotiated Rate	$8,856.00
Max. Negotiated Rate	$43,577.66
Rate for Payer: Affinity Essential Plan 1&2	$43,577.66
Rate for Payer: Affinity Essential Plan 3&4	$43,577.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,367.85
Rate for Payer: Amida Care Medicaid	$19,367.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,367.85
Rate for Payer: Fidelis Qualified Health Plan	$23,241.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,367.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,367.85
Rate for Payer: Healthfirst Commercial	$14,824.00
Rate for Payer: Healthfirst Essential Plan	$43,577.66
Rate for Payer: Healthfirst QHP	$8,856.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,367.85
Rate for Payer: SOMOS Essential	$43,577.66
Rate for Payer: United Healthcare Essential Plan 1&2	$43,577.66
Rate for Payer: United Healthcare Essential Plan 3&4	$43,577.66
Rate for Payer: United Healthcare Medicaid	$19,367.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,367.85

APR-DRG 1973: Peripheral & other vascular disorders

Facility

$50,412.15

Service Code	APR-DRG 1973
Min. Negotiated Rate	$12,792.00
Max. Negotiated Rate	$50,412.15
Rate for Payer: Affinity Essential Plan 1&2	$50,412.15
Rate for Payer: Affinity Essential Plan 3&4	$50,412.15
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,405.40
Rate for Payer: Amida Care Medicaid	$22,405.40
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,405.40
Rate for Payer: Fidelis Qualified Health Plan	$26,886.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,405.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,405.40
Rate for Payer: Healthfirst Commercial	$21,444.00
Rate for Payer: Healthfirst Essential Plan	$50,412.15
Rate for Payer: Healthfirst QHP	$12,792.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,405.40
Rate for Payer: SOMOS Essential	$50,412.15
Rate for Payer: United Healthcare Essential Plan 1&2	$50,412.15
Rate for Payer: United Healthcare Essential Plan 3&4	$50,412.15
Rate for Payer: United Healthcare Medicaid	$22,405.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,405.40

APR-DRG 1974: Peripheral & other vascular disorders

Facility

$80,011.84

Service Code	APR-DRG 1974
Min. Negotiated Rate	$25,004.00
Max. Negotiated Rate	$80,011.84
Rate for Payer: Affinity Essential Plan 1&2	$80,011.84
Rate for Payer: Affinity Essential Plan 3&4	$80,011.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,560.82
Rate for Payer: Amida Care Medicaid	$35,560.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,560.82
Rate for Payer: Fidelis Qualified Health Plan	$42,672.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,560.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,560.82
Rate for Payer: Healthfirst Commercial	$43,874.00
Rate for Payer: Healthfirst Essential Plan	$80,011.84
Rate for Payer: Healthfirst QHP	$25,004.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,560.82
Rate for Payer: SOMOS Essential	$80,011.84
Rate for Payer: United Healthcare Essential Plan 1&2	$80,011.84
Rate for Payer: United Healthcare Essential Plan 3&4	$80,011.84
Rate for Payer: United Healthcare Medicaid	$35,560.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,560.82

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