St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 1981: Angina pectoris & coronary atherosclerosis

Facility

$36,824.08

Service Code	APR-DRG 1981
Min. Negotiated Rate	$5,053.00
Max. Negotiated Rate	$36,824.08
Rate for Payer: Affinity Essential Plan 1&2	$36,824.08
Rate for Payer: Affinity Essential Plan 3&4	$36,824.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,366.26
Rate for Payer: Amida Care Medicaid	$16,366.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,366.26
Rate for Payer: Fidelis Qualified Health Plan	$19,639.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,366.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,366.26
Rate for Payer: Healthfirst Commercial	$8,836.00
Rate for Payer: Healthfirst Essential Plan	$36,824.08
Rate for Payer: Healthfirst QHP	$5,053.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,366.26
Rate for Payer: SOMOS Essential	$36,824.08
Rate for Payer: United Healthcare Essential Plan 1&2	$36,824.08
Rate for Payer: United Healthcare Essential Plan 3&4	$36,824.08
Rate for Payer: United Healthcare Medicaid	$16,366.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,366.26

APR-DRG 1982: Angina pectoris & coronary atherosclerosis

Facility

$39,040.11

Service Code	APR-DRG 1982
Min. Negotiated Rate	$6,107.00
Max. Negotiated Rate	$39,040.11
Rate for Payer: Affinity Essential Plan 1&2	$39,040.11
Rate for Payer: Affinity Essential Plan 3&4	$39,040.11
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,351.16
Rate for Payer: Amida Care Medicaid	$17,351.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,351.16
Rate for Payer: Fidelis Qualified Health Plan	$20,821.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,351.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,351.16
Rate for Payer: Healthfirst Commercial	$10,556.00
Rate for Payer: Healthfirst Essential Plan	$39,040.11
Rate for Payer: Healthfirst QHP	$6,107.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,351.16
Rate for Payer: SOMOS Essential	$39,040.11
Rate for Payer: United Healthcare Essential Plan 1&2	$39,040.11
Rate for Payer: United Healthcare Essential Plan 3&4	$39,040.11
Rate for Payer: United Healthcare Medicaid	$17,351.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,351.16

APR-DRG 1983: Angina pectoris & coronary atherosclerosis

Facility

$44,024.38

Service Code	APR-DRG 1983
Min. Negotiated Rate	$7,870.00
Max. Negotiated Rate	$44,024.38
Rate for Payer: Affinity Essential Plan 1&2	$44,024.38
Rate for Payer: Affinity Essential Plan 3&4	$44,024.38
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,566.39
Rate for Payer: Amida Care Medicaid	$19,566.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,566.39
Rate for Payer: Fidelis Qualified Health Plan	$23,479.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,566.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,566.39
Rate for Payer: Healthfirst Commercial	$15,856.00
Rate for Payer: Healthfirst Essential Plan	$44,024.38
Rate for Payer: Healthfirst QHP	$7,870.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,566.39
Rate for Payer: SOMOS Essential	$44,024.38
Rate for Payer: United Healthcare Essential Plan 1&2	$44,024.38
Rate for Payer: United Healthcare Essential Plan 3&4	$44,024.38
Rate for Payer: United Healthcare Medicaid	$19,566.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,566.39

APR-DRG 1984: Angina pectoris & coronary atherosclerosis

Facility

$72,217.08

Service Code	APR-DRG 1984
Min. Negotiated Rate	$13,272.00
Max. Negotiated Rate	$72,217.08
Rate for Payer: Affinity Essential Plan 1&2	$72,217.08
Rate for Payer: Affinity Essential Plan 3&4	$72,217.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,096.48
Rate for Payer: Amida Care Medicaid	$32,096.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,096.48
Rate for Payer: Fidelis Qualified Health Plan	$38,515.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,096.48
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,096.48
Rate for Payer: Healthfirst Commercial	$16,969.00
Rate for Payer: Healthfirst Essential Plan	$72,217.08
Rate for Payer: Healthfirst QHP	$13,272.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,096.48
Rate for Payer: SOMOS Essential	$72,217.08
Rate for Payer: United Healthcare Essential Plan 1&2	$72,217.08
Rate for Payer: United Healthcare Essential Plan 3&4	$72,217.08
Rate for Payer: United Healthcare Medicaid	$32,096.48
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,096.48

APR-DRG 1991: Hypertension

Facility

$37,601.44

Service Code	APR-DRG 1991
Min. Negotiated Rate	$5,256.00
Max. Negotiated Rate	$37,601.44
Rate for Payer: Affinity Essential Plan 1&2	$37,601.44
Rate for Payer: Affinity Essential Plan 3&4	$37,601.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,711.75
Rate for Payer: Amida Care Medicaid	$16,711.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,711.75
Rate for Payer: Fidelis Qualified Health Plan	$20,054.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,711.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,711.75
Rate for Payer: Healthfirst Commercial	$9,091.00
Rate for Payer: Healthfirst Essential Plan	$37,601.44
Rate for Payer: Healthfirst QHP	$5,256.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,711.75
Rate for Payer: SOMOS Essential	$37,601.44
Rate for Payer: United Healthcare Essential Plan 1&2	$37,601.44
Rate for Payer: United Healthcare Essential Plan 3&4	$37,601.44
Rate for Payer: United Healthcare Medicaid	$16,711.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,711.75

APR-DRG 1992: Hypertension

Facility

$40,061.92

Service Code	APR-DRG 1992
Min. Negotiated Rate	$6,463.00
Max. Negotiated Rate	$40,061.92
Rate for Payer: Affinity Essential Plan 1&2	$40,061.92
Rate for Payer: Affinity Essential Plan 3&4	$40,061.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,805.30
Rate for Payer: Amida Care Medicaid	$17,805.30
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,805.30
Rate for Payer: Fidelis Qualified Health Plan	$21,366.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,805.30
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,805.30
Rate for Payer: Healthfirst Commercial	$11,035.00
Rate for Payer: Healthfirst Essential Plan	$40,061.92
Rate for Payer: Healthfirst QHP	$6,463.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,805.30
Rate for Payer: SOMOS Essential	$40,061.92
Rate for Payer: United Healthcare Essential Plan 1&2	$40,061.92
Rate for Payer: United Healthcare Essential Plan 3&4	$40,061.92
Rate for Payer: United Healthcare Medicaid	$17,805.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,805.30

APR-DRG 1993: Hypertension

Facility

$46,032.88

Service Code	APR-DRG 1993
Min. Negotiated Rate	$9,195.00
Max. Negotiated Rate	$46,032.88
Rate for Payer: Affinity Essential Plan 1&2	$46,032.88
Rate for Payer: Affinity Essential Plan 3&4	$46,032.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,459.06
Rate for Payer: Amida Care Medicaid	$20,459.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,459.06
Rate for Payer: Fidelis Qualified Health Plan	$24,550.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,459.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,459.06
Rate for Payer: Healthfirst Commercial	$16,723.00
Rate for Payer: Healthfirst Essential Plan	$46,032.88
Rate for Payer: Healthfirst QHP	$9,195.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,459.06
Rate for Payer: SOMOS Essential	$46,032.88
Rate for Payer: United Healthcare Essential Plan 1&2	$46,032.88
Rate for Payer: United Healthcare Essential Plan 3&4	$46,032.88
Rate for Payer: United Healthcare Medicaid	$20,459.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,459.06

APR-DRG 1994: Hypertension

Facility

$72,843.21

Service Code	APR-DRG 1994
Min. Negotiated Rate	$17,378.00
Max. Negotiated Rate	$72,843.21
Rate for Payer: Affinity Essential Plan 1&2	$72,843.21
Rate for Payer: Affinity Essential Plan 3&4	$72,843.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,374.76
Rate for Payer: Amida Care Medicaid	$32,374.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,374.76
Rate for Payer: Fidelis Qualified Health Plan	$38,849.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,374.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,374.76
Rate for Payer: Healthfirst Commercial	$43,335.00
Rate for Payer: Healthfirst Essential Plan	$72,843.21
Rate for Payer: Healthfirst QHP	$17,378.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,374.76
Rate for Payer: SOMOS Essential	$72,843.21
Rate for Payer: United Healthcare Essential Plan 1&2	$72,843.21
Rate for Payer: United Healthcare Essential Plan 3&4	$72,843.21
Rate for Payer: United Healthcare Medicaid	$32,374.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,374.76

APR-DRG 2001: Cardiac structural & valvular disorders

Facility

$38,565.25

Service Code	APR-DRG 2001
Min. Negotiated Rate	$5,691.00
Max. Negotiated Rate	$38,565.25
Rate for Payer: Affinity Essential Plan 1&2	$38,565.25
Rate for Payer: Affinity Essential Plan 3&4	$38,565.25
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,140.11
Rate for Payer: Amida Care Medicaid	$17,140.11
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,140.11
Rate for Payer: Fidelis Qualified Health Plan	$20,568.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,140.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,140.11
Rate for Payer: Healthfirst Commercial	$10,380.00
Rate for Payer: Healthfirst Essential Plan	$38,565.25
Rate for Payer: Healthfirst QHP	$5,691.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,140.11
Rate for Payer: SOMOS Essential	$38,565.25
Rate for Payer: United Healthcare Essential Plan 1&2	$38,565.25
Rate for Payer: United Healthcare Essential Plan 3&4	$38,565.25
Rate for Payer: United Healthcare Medicaid	$17,140.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,140.11

APR-DRG 2002: Cardiac structural & valvular disorders

Facility

$41,884.00

Service Code	APR-DRG 2002
Min. Negotiated Rate	$7,658.00
Max. Negotiated Rate	$41,884.00
Rate for Payer: Affinity Essential Plan 1&2	$41,884.00
Rate for Payer: Affinity Essential Plan 3&4	$41,884.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,615.11
Rate for Payer: Amida Care Medicaid	$18,615.11
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,615.11
Rate for Payer: Fidelis Qualified Health Plan	$22,338.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,615.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,615.11
Rate for Payer: Healthfirst Commercial	$13,382.00
Rate for Payer: Healthfirst Essential Plan	$41,884.00
Rate for Payer: Healthfirst QHP	$7,658.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,615.11
Rate for Payer: SOMOS Essential	$41,884.00
Rate for Payer: United Healthcare Essential Plan 1&2	$41,884.00
Rate for Payer: United Healthcare Essential Plan 3&4	$41,884.00
Rate for Payer: United Healthcare Medicaid	$18,615.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,615.11

APR-DRG 2003: Cardiac structural & valvular disorders

Facility

$51,655.59

Service Code	APR-DRG 2003
Min. Negotiated Rate	$12,216.00
Max. Negotiated Rate	$51,655.59
Rate for Payer: Affinity Essential Plan 1&2	$51,655.59
Rate for Payer: Affinity Essential Plan 3&4	$51,655.59
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,958.04
Rate for Payer: Amida Care Medicaid	$22,958.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,958.04
Rate for Payer: Fidelis Qualified Health Plan	$27,549.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,958.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,958.04
Rate for Payer: Healthfirst Commercial	$19,515.00
Rate for Payer: Healthfirst Essential Plan	$51,655.59
Rate for Payer: Healthfirst QHP	$12,216.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,958.04
Rate for Payer: SOMOS Essential	$51,655.59
Rate for Payer: United Healthcare Essential Plan 1&2	$51,655.59
Rate for Payer: United Healthcare Essential Plan 3&4	$51,655.59
Rate for Payer: United Healthcare Medicaid	$22,958.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,958.04

APR-DRG 2004: Cardiac structural & valvular disorders

Facility

$98,928.92

Service Code	APR-DRG 2004
Min. Negotiated Rate	$43,968.41
Max. Negotiated Rate	$98,928.92
Rate for Payer: Affinity Essential Plan 1&2	$98,928.92
Rate for Payer: Affinity Essential Plan 3&4	$98,928.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$43,968.41
Rate for Payer: Amida Care Medicaid	$43,968.41
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,968.41
Rate for Payer: Fidelis Qualified Health Plan	$52,762.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,968.41
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,968.41
Rate for Payer: Healthfirst Commercial	$52,495.00
Rate for Payer: Healthfirst Essential Plan	$98,928.92
Rate for Payer: Healthfirst QHP	$48,764.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,968.41
Rate for Payer: SOMOS Essential	$98,928.92
Rate for Payer: United Healthcare Essential Plan 1&2	$98,928.92
Rate for Payer: United Healthcare Essential Plan 3&4	$98,928.92
Rate for Payer: United Healthcare Medicaid	$43,968.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,968.41

APR-DRG 2011: Cardiac arrhythmia & conduction disorders

Facility

$37,249.70

Service Code	APR-DRG 2011
Min. Negotiated Rate	$5,453.00
Max. Negotiated Rate	$37,249.70
Rate for Payer: Affinity Essential Plan 1&2	$37,249.70
Rate for Payer: Affinity Essential Plan 3&4	$37,249.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,555.42
Rate for Payer: Amida Care Medicaid	$16,555.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,555.42
Rate for Payer: Fidelis Qualified Health Plan	$19,866.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,555.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,555.42
Rate for Payer: Healthfirst Commercial	$9,341.00
Rate for Payer: Healthfirst Essential Plan	$37,249.70
Rate for Payer: Healthfirst QHP	$5,453.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,555.42
Rate for Payer: SOMOS Essential	$37,249.70
Rate for Payer: United Healthcare Essential Plan 1&2	$37,249.70
Rate for Payer: United Healthcare Essential Plan 3&4	$37,249.70
Rate for Payer: United Healthcare Medicaid	$16,555.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,555.42

APR-DRG 2012: Cardiac arrhythmia & conduction disorders

Facility

$40,630.00

Service Code	APR-DRG 2012
Min. Negotiated Rate	$7,085.00
Max. Negotiated Rate	$40,630.00
Rate for Payer: Affinity Essential Plan 1&2	$40,630.00
Rate for Payer: Affinity Essential Plan 3&4	$40,630.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,057.78
Rate for Payer: Amida Care Medicaid	$18,057.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,057.78
Rate for Payer: Fidelis Qualified Health Plan	$21,669.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,057.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,057.78
Rate for Payer: Healthfirst Commercial	$12,809.00
Rate for Payer: Healthfirst Essential Plan	$40,630.00
Rate for Payer: Healthfirst QHP	$7,085.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,057.78
Rate for Payer: SOMOS Essential	$40,630.00
Rate for Payer: United Healthcare Essential Plan 1&2	$40,630.00
Rate for Payer: United Healthcare Essential Plan 3&4	$40,630.00
Rate for Payer: United Healthcare Medicaid	$18,057.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,057.78

APR-DRG 2013: Cardiac arrhythmia & conduction disorders

Facility

$48,723.75

Service Code	APR-DRG 2013
Min. Negotiated Rate	$10,578.00
Max. Negotiated Rate	$48,723.75
Rate for Payer: Affinity Essential Plan 1&2	$48,723.75
Rate for Payer: Affinity Essential Plan 3&4	$48,723.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,655.00
Rate for Payer: Amida Care Medicaid	$21,655.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,655.00
Rate for Payer: Fidelis Qualified Health Plan	$25,986.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,655.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,655.00
Rate for Payer: Healthfirst Commercial	$20,343.00
Rate for Payer: Healthfirst Essential Plan	$48,723.75
Rate for Payer: Healthfirst QHP	$10,578.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,655.00
Rate for Payer: SOMOS Essential	$48,723.75
Rate for Payer: United Healthcare Essential Plan 1&2	$48,723.75
Rate for Payer: United Healthcare Essential Plan 3&4	$48,723.75
Rate for Payer: United Healthcare Medicaid	$21,655.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,655.00

APR-DRG 2014: Cardiac arrhythmia & conduction disorders

Facility

$74,315.27

Service Code	APR-DRG 2014
Min. Negotiated Rate	$20,957.00
Max. Negotiated Rate	$74,315.27
Rate for Payer: Affinity Essential Plan 1&2	$74,315.27
Rate for Payer: Affinity Essential Plan 3&4	$74,315.27
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,029.01
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	$43,420.00
Rate for Payer: Healthfirst Essential Plan	$74,315.27
Rate for Payer: Healthfirst QHP	$20,957.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,029.01
Rate for Payer: SOMOS Essential	$74,315.27
Rate for Payer: United Healthcare Essential Plan 1&2	$74,315.27
Rate for Payer: United Healthcare Essential Plan 3&4	$74,315.27
Rate for Payer: United Healthcare Medicaid	$33,029.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,029.01

APR-DRG 2031: Chest pain

Facility

$36,569.07

Service Code	APR-DRG 2031
Min. Negotiated Rate	$4,791.00
Max. Negotiated Rate	$36,569.07
Rate for Payer: Affinity Essential Plan 1&2	$36,569.07
Rate for Payer: Affinity Essential Plan 3&4	$36,569.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,252.92
Rate for Payer: Amida Care Medicaid	$16,252.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,252.92
Rate for Payer: Fidelis Qualified Health Plan	$19,503.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,252.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,252.92
Rate for Payer: Healthfirst Commercial	$8,351.00
Rate for Payer: Healthfirst Essential Plan	$36,569.07
Rate for Payer: Healthfirst QHP	$4,791.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,252.92
Rate for Payer: SOMOS Essential	$36,569.07
Rate for Payer: United Healthcare Essential Plan 1&2	$36,569.07
Rate for Payer: United Healthcare Essential Plan 3&4	$36,569.07
Rate for Payer: United Healthcare Medicaid	$16,252.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,252.92

APR-DRG 2032: Chest pain

Facility

$38,283.84

Service Code	APR-DRG 2032
Min. Negotiated Rate	$5,575.00
Max. Negotiated Rate	$38,283.84
Rate for Payer: Affinity Essential Plan 1&2	$38,283.84
Rate for Payer: Affinity Essential Plan 3&4	$38,283.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,015.04
Rate for Payer: Amida Care Medicaid	$17,015.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,015.04
Rate for Payer: Fidelis Qualified Health Plan	$20,418.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,015.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,015.04
Rate for Payer: Healthfirst Commercial	$9,770.00
Rate for Payer: Healthfirst Essential Plan	$38,283.84
Rate for Payer: Healthfirst QHP	$5,575.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,015.04
Rate for Payer: SOMOS Essential	$38,283.84
Rate for Payer: United Healthcare Essential Plan 1&2	$38,283.84
Rate for Payer: United Healthcare Essential Plan 3&4	$38,283.84
Rate for Payer: United Healthcare Medicaid	$17,015.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,015.04

APR-DRG 2033: Chest pain

Facility

$42,058.10

Service Code	APR-DRG 2033
Min. Negotiated Rate	$7,173.00
Max. Negotiated Rate	$42,058.10
Rate for Payer: Affinity Essential Plan 1&2	$42,058.10
Rate for Payer: Affinity Essential Plan 3&4	$42,058.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,692.49
Rate for Payer: Amida Care Medicaid	$18,692.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,692.49
Rate for Payer: Fidelis Qualified Health Plan	$22,430.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,692.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,692.49
Rate for Payer: Healthfirst Commercial	$13,552.00
Rate for Payer: Healthfirst Essential Plan	$42,058.10
Rate for Payer: Healthfirst QHP	$7,173.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,692.49
Rate for Payer: SOMOS Essential	$42,058.10
Rate for Payer: United Healthcare Essential Plan 1&2	$42,058.10
Rate for Payer: United Healthcare Essential Plan 3&4	$42,058.10
Rate for Payer: United Healthcare Medicaid	$18,692.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,692.49

APR-DRG 2034: Chest pain

Facility

$71,065.10

Service Code	APR-DRG 2034
Min. Negotiated Rate	$11,434.00
Max. Negotiated Rate	$71,065.10
Rate for Payer: Affinity Essential Plan 1&2	$71,065.10
Rate for Payer: Affinity Essential Plan 3&4	$71,065.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$31,584.49
Rate for Payer: Amida Care Medicaid	$31,584.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,584.49
Rate for Payer: Fidelis Qualified Health Plan	$37,901.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,584.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,584.49
Rate for Payer: Healthfirst Commercial	$33,028.00
Rate for Payer: Healthfirst Essential Plan	$71,065.10
Rate for Payer: Healthfirst QHP	$11,434.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,584.49
Rate for Payer: SOMOS Essential	$71,065.10
Rate for Payer: United Healthcare Essential Plan 1&2	$71,065.10
Rate for Payer: United Healthcare Essential Plan 3&4	$71,065.10
Rate for Payer: United Healthcare Medicaid	$31,584.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,584.49

APR-DRG 2041: Syncope & collapse

Facility

$37,738.62

Service Code	APR-DRG 2041
Min. Negotiated Rate	$5,384.00
Max. Negotiated Rate	$37,738.62
Rate for Payer: Affinity Essential Plan 1&2	$37,738.62
Rate for Payer: Affinity Essential Plan 3&4	$37,738.62
Rate for Payer: Affinity Medicaid/CHP/HARP	$16,772.72
Rate for Payer: Amida Care Medicaid	$16,772.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,772.72
Rate for Payer: Fidelis Qualified Health Plan	$20,127.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,772.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,772.72
Rate for Payer: Healthfirst Commercial	$9,282.00
Rate for Payer: Healthfirst Essential Plan	$37,738.62
Rate for Payer: Healthfirst QHP	$5,384.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,772.72
Rate for Payer: SOMOS Essential	$37,738.62
Rate for Payer: United Healthcare Essential Plan 1&2	$37,738.62
Rate for Payer: United Healthcare Essential Plan 3&4	$37,738.62
Rate for Payer: United Healthcare Medicaid	$16,772.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,772.72

APR-DRG 2042: Syncope & collapse

Facility

$39,755.90

Service Code	APR-DRG 2042
Min. Negotiated Rate	$6,476.00
Max. Negotiated Rate	$39,755.90
Rate for Payer: Affinity Essential Plan 1&2	$39,755.90
Rate for Payer: Affinity Essential Plan 3&4	$39,755.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,669.29
Rate for Payer: Amida Care Medicaid	$17,669.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,669.29
Rate for Payer: Fidelis Qualified Health Plan	$21,203.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,669.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,669.29
Rate for Payer: Healthfirst Commercial	$11,327.00
Rate for Payer: Healthfirst Essential Plan	$39,755.90
Rate for Payer: Healthfirst QHP	$6,476.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,669.29
Rate for Payer: SOMOS Essential	$39,755.90
Rate for Payer: United Healthcare Essential Plan 1&2	$39,755.90
Rate for Payer: United Healthcare Essential Plan 3&4	$39,755.90
Rate for Payer: United Healthcare Medicaid	$17,669.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,669.29

APR-DRG 2043: Syncope & collapse

Facility

$44,757.79

Service Code	APR-DRG 2043
Min. Negotiated Rate	$8,637.00
Max. Negotiated Rate	$44,757.79
Rate for Payer: Affinity Essential Plan 1&2	$44,757.79
Rate for Payer: Affinity Essential Plan 3&4	$44,757.79
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,892.35
Rate for Payer: Amida Care Medicaid	$19,892.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,892.35
Rate for Payer: Fidelis Qualified Health Plan	$23,870.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,892.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,892.35
Rate for Payer: Healthfirst Commercial	$16,471.00
Rate for Payer: Healthfirst Essential Plan	$44,757.79
Rate for Payer: Healthfirst QHP	$8,637.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,892.35
Rate for Payer: SOMOS Essential	$44,757.79
Rate for Payer: United Healthcare Essential Plan 1&2	$44,757.79
Rate for Payer: United Healthcare Essential Plan 3&4	$44,757.79
Rate for Payer: United Healthcare Medicaid	$19,892.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,892.35

APR-DRG 2044: Syncope & collapse

Facility

$66,940.85

Service Code	APR-DRG 2044
Min. Negotiated Rate	$17,278.00
Max. Negotiated Rate	$66,940.85
Rate for Payer: Affinity Essential Plan 1&2	$66,940.85
Rate for Payer: Affinity Essential Plan 3&4	$66,940.85
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,751.49
Rate for Payer: Amida Care Medicaid	$29,751.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,751.49
Rate for Payer: Fidelis Qualified Health Plan	$35,701.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,751.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,751.49
Rate for Payer: Healthfirst Commercial	$38,194.00
Rate for Payer: Healthfirst Essential Plan	$66,940.85
Rate for Payer: Healthfirst QHP	$17,278.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,751.49
Rate for Payer: SOMOS Essential	$66,940.85
Rate for Payer: United Healthcare Essential Plan 1&2	$66,940.85
Rate for Payer: United Healthcare Essential Plan 3&4	$66,940.85
Rate for Payer: United Healthcare Medicaid	$29,751.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,751.49

APR-DRG 2051: Cardiomyopathy

Facility

$39,977.50

Service Code	APR-DRG 2051
Min. Negotiated Rate	$6,012.00
Max. Negotiated Rate	$39,977.50
Rate for Payer: Affinity Essential Plan 1&2	$39,977.50
Rate for Payer: Affinity Essential Plan 3&4	$39,977.50
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,767.78
Rate for Payer: Amida Care Medicaid	$17,767.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,767.78
Rate for Payer: Fidelis Qualified Health Plan	$21,321.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,767.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,767.78
Rate for Payer: Healthfirst Commercial	$10,662.00
Rate for Payer: Healthfirst Essential Plan	$39,977.50
Rate for Payer: Healthfirst QHP	$6,012.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,767.78
Rate for Payer: SOMOS Essential	$39,977.50
Rate for Payer: United Healthcare Essential Plan 1&2	$39,977.50
Rate for Payer: United Healthcare Essential Plan 3&4	$39,977.50
Rate for Payer: United Healthcare Medicaid	$17,767.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,767.78

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