St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 6301: Neonate birthwt >2499g w major cardiovascular procedure

Facility IP

$90,298.76

Service Code	APR-DRG 6301
Min. Negotiated Rate	$26,170.00
Max. Negotiated Rate	$90,298.76
Rate for Payer: Amida Care Medicaid	$40,132.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$40,132.78
Rate for Payer: Fidelis Qualified Health Plan	$48,159.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$40,132.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40,132.78
Rate for Payer: Healthfirst Commercial	$51,521.00
Rate for Payer: Healthfirst Essential Plan	$90,298.76
Rate for Payer: Healthfirst QHP	$26,170.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40,132.78
Rate for Payer: SOMOS Essential	$90,298.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40,132.78

APR-DRG 6302: Neonate birthwt >2499g w major cardiovascular procedure

Facility IP

$92,724.08

Service Code	APR-DRG 6302
Min. Negotiated Rate	$29,998.00
Max. Negotiated Rate	$92,724.08
Rate for Payer: Amida Care Medicaid	$41,210.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$41,210.70
Rate for Payer: Fidelis Qualified Health Plan	$49,452.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$41,210.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41,210.70
Rate for Payer: Healthfirst Commercial	$57,432.00
Rate for Payer: Healthfirst Essential Plan	$92,724.08
Rate for Payer: Healthfirst QHP	$29,998.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41,210.70
Rate for Payer: SOMOS Essential	$92,724.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$41,210.70

APR-DRG 6303: Neonate birthwt >2499g w major cardiovascular procedure

Facility IP

$133,857.63

Service Code	APR-DRG 6303
Min. Negotiated Rate	$49,009.00
Max. Negotiated Rate	$133,857.63
Rate for Payer: Amida Care Medicaid	$59,492.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59,492.28
Rate for Payer: Fidelis Qualified Health Plan	$71,390.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$59,492.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$59,492.28
Rate for Payer: Healthfirst Commercial	$103,626.00
Rate for Payer: Healthfirst Essential Plan	$133,857.63
Rate for Payer: Healthfirst QHP	$49,009.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59,492.28
Rate for Payer: SOMOS Essential	$133,857.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$59,492.28

APR-DRG 6304: Neonate birthwt >2499g w major cardiovascular procedure

Facility IP

$244,728.99

Service Code	APR-DRG 6304
Min. Negotiated Rate	$87,259.00
Max. Negotiated Rate	$244,728.99
Rate for Payer: Amida Care Medicaid	$108,768.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$108,768.44
Rate for Payer: Fidelis Qualified Health Plan	$130,522.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$108,768.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$108,768.44
Rate for Payer: Healthfirst Commercial	$224,416.00
Rate for Payer: Healthfirst Essential Plan	$244,728.99
Rate for Payer: Healthfirst QHP	$87,259.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108,768.44
Rate for Payer: SOMOS Essential	$244,728.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$108,768.44

APR-DRG 6311: Neonate birthwt >2499g w other major procedure

Facility IP

$58,277.27

Service Code	APR-DRG 6311
Min. Negotiated Rate	$15,186.00
Max. Negotiated Rate	$58,277.27
Rate for Payer: Amida Care Medicaid	$25,901.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,901.01
Rate for Payer: Fidelis Qualified Health Plan	$31,081.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,901.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,901.01
Rate for Payer: Healthfirst Commercial	$31,804.00
Rate for Payer: Healthfirst Essential Plan	$58,277.27
Rate for Payer: Healthfirst QHP	$15,186.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,901.01
Rate for Payer: SOMOS Essential	$58,277.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,901.01

APR-DRG 6312: Neonate birthwt >2499g w other major procedure

Facility IP

$81,244.73

Service Code	APR-DRG 6312
Min. Negotiated Rate	$27,711.00
Max. Negotiated Rate	$81,244.73
Rate for Payer: Amida Care Medicaid	$36,108.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,108.77
Rate for Payer: Fidelis Qualified Health Plan	$43,330.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,108.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,108.77
Rate for Payer: Healthfirst Commercial	$59,069.00
Rate for Payer: Healthfirst Essential Plan	$81,244.73
Rate for Payer: Healthfirst QHP	$27,711.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,108.77
Rate for Payer: SOMOS Essential	$81,244.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,108.77

APR-DRG 6313: Neonate birthwt >2499g w other major procedure

Facility IP

$115,399.60

Service Code	APR-DRG 6313
Min. Negotiated Rate	$46,863.00
Max. Negotiated Rate	$115,399.60
Rate for Payer: Amida Care Medicaid	$51,288.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$51,288.71
Rate for Payer: Fidelis Qualified Health Plan	$61,546.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$51,288.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$51,288.71
Rate for Payer: Healthfirst Commercial	$94,612.00
Rate for Payer: Healthfirst Essential Plan	$115,399.60
Rate for Payer: Healthfirst QHP	$46,863.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$51,288.71
Rate for Payer: SOMOS Essential	$115,399.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$51,288.71

APR-DRG 6314: Neonate birthwt >2499g w other major procedure

Facility IP

$214,547.15

Service Code	APR-DRG 6314
Min. Negotiated Rate	$95,354.29
Max. Negotiated Rate	$214,547.15
Rate for Payer: Amida Care Medicaid	$95,354.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$95,354.29
Rate for Payer: Fidelis Qualified Health Plan	$114,425.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$95,354.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$95,354.29
Rate for Payer: Healthfirst Commercial	$176,144.00
Rate for Payer: Healthfirst Essential Plan	$214,547.15
Rate for Payer: Healthfirst QHP	$98,134.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$95,354.29
Rate for Payer: SOMOS Essential	$214,547.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$95,354.29

APR-DRG 6331: Neonate birthwt >2499g w major anomaly

Facility IP

$34,599.26

Service Code	APR-DRG 6331
Min. Negotiated Rate	$3,840.00
Max. Negotiated Rate	$34,599.26
Rate for Payer: Amida Care Medicaid	$15,377.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$15,377.45
Rate for Payer: Fidelis Qualified Health Plan	$18,452.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,377.45
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$15,377.45
Rate for Payer: Healthfirst Commercial	$7,083.00
Rate for Payer: Healthfirst Essential Plan	$34,599.26
Rate for Payer: Healthfirst QHP	$3,840.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,377.45
Rate for Payer: SOMOS Essential	$34,599.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$15,377.45

APR-DRG 6332: Neonate birthwt >2499g w major anomaly

Facility IP

$45,656.50

Service Code	APR-DRG 6332
Min. Negotiated Rate	$8,821.00
Max. Negotiated Rate	$45,656.50
Rate for Payer: Amida Care Medicaid	$20,291.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,291.78
Rate for Payer: Fidelis Qualified Health Plan	$24,350.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,291.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,291.78
Rate for Payer: Healthfirst Commercial	$15,727.00
Rate for Payer: Healthfirst Essential Plan	$45,656.50
Rate for Payer: Healthfirst QHP	$8,821.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,291.78
Rate for Payer: SOMOS Essential	$45,656.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,291.78

APR-DRG 6333: Neonate birthwt >2499g w major anomaly

Facility IP

$71,789.72

Service Code	APR-DRG 6333
Min. Negotiated Rate	$18,583.00
Max. Negotiated Rate	$71,789.72
Rate for Payer: Amida Care Medicaid	$31,906.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,906.54
Rate for Payer: Fidelis Qualified Health Plan	$38,287.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,906.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,906.54
Rate for Payer: Healthfirst Commercial	$32,884.00
Rate for Payer: Healthfirst Essential Plan	$71,789.72
Rate for Payer: Healthfirst QHP	$18,583.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,906.54
Rate for Payer: SOMOS Essential	$71,789.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,906.54

APR-DRG 6334: Neonate birthwt >2499g w major anomaly

Facility IP

$123,804.63

Service Code	APR-DRG 6334
Min. Negotiated Rate	$37,593.00
Max. Negotiated Rate	$123,804.63
Rate for Payer: Amida Care Medicaid	$55,024.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$55,024.28
Rate for Payer: Fidelis Qualified Health Plan	$66,029.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$55,024.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$55,024.28
Rate for Payer: Healthfirst Commercial	$85,268.00
Rate for Payer: Healthfirst Essential Plan	$123,804.63
Rate for Payer: Healthfirst QHP	$37,593.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55,024.28
Rate for Payer: SOMOS Essential	$123,804.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$55,024.28

APR-DRG 6341: Neonate, birthwt >2499g w resp dist synd/oth maj resp cond

Facility IP

$43,785.20

Service Code	APR-DRG 6341
Min. Negotiated Rate	$7,869.00
Max. Negotiated Rate	$43,785.20
Rate for Payer: Amida Care Medicaid	$19,460.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,460.09
Rate for Payer: Fidelis Qualified Health Plan	$23,352.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,460.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,460.09
Rate for Payer: Healthfirst Commercial	$14,054.00
Rate for Payer: Healthfirst Essential Plan	$43,785.20
Rate for Payer: Healthfirst QHP	$7,869.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,460.09
Rate for Payer: SOMOS Essential	$43,785.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,460.09

APR-DRG 6342: Neonate, birthwt >2499g w resp dist synd/oth maj resp cond

Facility IP

$53,088.98

Service Code	APR-DRG 6342
Min. Negotiated Rate	$12,425.00
Max. Negotiated Rate	$53,088.98
Rate for Payer: Amida Care Medicaid	$23,595.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,595.10
Rate for Payer: Fidelis Qualified Health Plan	$28,314.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,595.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,595.10
Rate for Payer: Healthfirst Commercial	$21,390.00
Rate for Payer: Healthfirst Essential Plan	$53,088.98
Rate for Payer: Healthfirst QHP	$12,425.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,595.10
Rate for Payer: SOMOS Essential	$53,088.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,595.10

APR-DRG 6343: Neonate, birthwt >2499g w resp dist synd/oth maj resp cond

Facility IP

$69,253.60

Service Code	APR-DRG 6343
Min. Negotiated Rate	$18,584.00
Max. Negotiated Rate	$69,253.60
Rate for Payer: Amida Care Medicaid	$30,779.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,779.38
Rate for Payer: Fidelis Qualified Health Plan	$36,935.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,779.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,779.38
Rate for Payer: Healthfirst Commercial	$34,215.00
Rate for Payer: Healthfirst Essential Plan	$69,253.60
Rate for Payer: Healthfirst QHP	$18,584.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,779.38
Rate for Payer: SOMOS Essential	$69,253.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,779.38

APR-DRG 6344: Neonate, birthwt >2499g w resp dist synd/oth maj resp cond

Facility IP

$100,582.16

Service Code	APR-DRG 6344
Min. Negotiated Rate	$34,196.00
Max. Negotiated Rate	$100,582.16
Rate for Payer: Amida Care Medicaid	$44,703.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$44,703.18
Rate for Payer: Fidelis Qualified Health Plan	$53,643.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$44,703.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$44,703.18
Rate for Payer: Healthfirst Commercial	$65,432.00
Rate for Payer: Healthfirst Essential Plan	$100,582.16
Rate for Payer: Healthfirst QHP	$34,196.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$44,703.18
Rate for Payer: SOMOS Essential	$100,582.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$44,703.18

APR-DRG 6361: Neonate birthwt >2499g w congenital/perinatal infection

Facility IP

$47,008.98

Service Code	APR-DRG 6361
Min. Negotiated Rate	$9,067.00
Max. Negotiated Rate	$47,008.98
Rate for Payer: Amida Care Medicaid	$20,892.88
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,892.88
Rate for Payer: Fidelis Qualified Health Plan	$25,071.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,892.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,892.88
Rate for Payer: Healthfirst Commercial	$14,658.00
Rate for Payer: Healthfirst Essential Plan	$47,008.98
Rate for Payer: Healthfirst QHP	$9,067.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,892.88
Rate for Payer: SOMOS Essential	$47,008.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,892.88

APR-DRG 6362: Neonate birthwt >2499g w congenital/perinatal infection

Facility IP

$53,210.32

Service Code	APR-DRG 6362
Min. Negotiated Rate	$12,841.00
Max. Negotiated Rate	$53,210.32
Rate for Payer: Amida Care Medicaid	$23,649.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,649.03
Rate for Payer: Fidelis Qualified Health Plan	$28,378.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,649.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,649.03
Rate for Payer: Healthfirst Commercial	$20,826.00
Rate for Payer: Healthfirst Essential Plan	$53,210.32
Rate for Payer: Healthfirst QHP	$12,841.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,649.03
Rate for Payer: SOMOS Essential	$53,210.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,649.03

APR-DRG 6363: Neonate birthwt >2499g w congenital/perinatal infection

Facility IP

$65,822.29

Service Code	APR-DRG 6363
Min. Negotiated Rate	$18,758.00
Max. Negotiated Rate	$65,822.29
Rate for Payer: Amida Care Medicaid	$29,254.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,254.35
Rate for Payer: Fidelis Qualified Health Plan	$35,105.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,254.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,254.35
Rate for Payer: Healthfirst Commercial	$35,196.00
Rate for Payer: Healthfirst Essential Plan	$65,822.29
Rate for Payer: Healthfirst QHP	$18,758.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,254.35
Rate for Payer: SOMOS Essential	$65,822.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,254.35

APR-DRG 6364: Neonate birthwt >2499g w congenital/perinatal infection

Facility IP

$76,807.42

Service Code	APR-DRG 6364
Min. Negotiated Rate	$27,039.00
Max. Negotiated Rate	$76,807.42
Rate for Payer: Amida Care Medicaid	$34,136.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,136.63
Rate for Payer: Fidelis Qualified Health Plan	$40,963.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,136.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,136.63
Rate for Payer: Healthfirst Commercial	$36,495.00
Rate for Payer: Healthfirst Essential Plan	$76,807.42
Rate for Payer: Healthfirst QHP	$27,039.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,136.63
Rate for Payer: SOMOS Essential	$76,807.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,136.63

APR-DRG 6391: Neonate birthwt >2499g w other significant condition

Facility IP

$38,712.98

Service Code	APR-DRG 6391
Min. Negotiated Rate	$5,526.00
Max. Negotiated Rate	$38,712.98
Rate for Payer: Amida Care Medicaid	$17,205.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,205.77
Rate for Payer: Fidelis Qualified Health Plan	$20,646.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,205.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,205.77
Rate for Payer: Healthfirst Commercial	$10,416.00
Rate for Payer: Healthfirst Essential Plan	$38,712.98
Rate for Payer: Healthfirst QHP	$5,526.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,205.77
Rate for Payer: SOMOS Essential	$38,712.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,205.77

APR-DRG 6392: Neonate birthwt >2499g w other significant condition

Facility IP

$52,447.03

Service Code	APR-DRG 6392
Min. Negotiated Rate	$12,248.00
Max. Negotiated Rate	$52,447.03
Rate for Payer: Amida Care Medicaid	$23,309.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,309.79
Rate for Payer: Fidelis Qualified Health Plan	$27,971.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,309.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,309.79
Rate for Payer: Healthfirst Commercial	$21,012.00
Rate for Payer: Healthfirst Essential Plan	$52,447.03
Rate for Payer: Healthfirst QHP	$12,248.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,309.79
Rate for Payer: SOMOS Essential	$52,447.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,309.79

APR-DRG 6393: Neonate birthwt >2499g w other significant condition

Facility IP

$62,420.87

Service Code	APR-DRG 6393
Min. Negotiated Rate	$16,201.00
Max. Negotiated Rate	$62,420.87
Rate for Payer: Amida Care Medicaid	$27,742.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,742.61
Rate for Payer: Fidelis Qualified Health Plan	$33,291.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,742.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,742.61
Rate for Payer: Healthfirst Commercial	$32,160.00
Rate for Payer: Healthfirst Essential Plan	$62,420.87
Rate for Payer: Healthfirst QHP	$16,201.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,742.61
Rate for Payer: SOMOS Essential	$62,420.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,742.61

APR-DRG 6394: Neonate birthwt >2499g w other significant condition

Facility IP

$97,078.72

Service Code	APR-DRG 6394
Min. Negotiated Rate	$24,364.00
Max. Negotiated Rate	$97,078.72
Rate for Payer: Amida Care Medicaid	$43,146.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,146.10
Rate for Payer: Fidelis Qualified Health Plan	$51,775.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,146.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,146.10
Rate for Payer: Healthfirst Commercial	$53,562.00
Rate for Payer: Healthfirst Essential Plan	$97,078.72
Rate for Payer: Healthfirst QHP	$24,364.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,146.10
Rate for Payer: SOMOS Essential	$97,078.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,146.10

APR-DRG 6401: Neonate birthwt >2499g, normal newborn or neonate w other problem

Facility IP

$32,719.16

Service Code	APR-DRG 6401
Min. Negotiated Rate	$3,008.00
Max. Negotiated Rate	$32,719.16
Rate for Payer: Amida Care Medicaid	$14,541.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$14,541.85
Rate for Payer: Fidelis Qualified Health Plan	$17,450.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$14,541.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$14,541.85
Rate for Payer: Healthfirst Commercial	$5,367.00
Rate for Payer: Healthfirst Essential Plan	$32,719.16
Rate for Payer: Healthfirst QHP	$3,008.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,541.85
Rate for Payer: SOMOS Essential	$32,719.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$14,541.85

Price Transparency.

All Charges