St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 2233: Other small & large bowel procedures

Facility

$76,431.04

Service Code	APR-DRG 2233
Min. Negotiated Rate	$26,916.00
Max. Negotiated Rate	$76,431.04
Rate for Payer: Affinity Essential Plan 1&2	$76,431.04
Rate for Payer: Affinity Essential Plan 3&4	$76,431.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,969.35
Rate for Payer: Amida Care Medicaid	$33,969.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,969.35
Rate for Payer: Fidelis Qualified Health Plan	$40,763.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,969.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,969.35
Rate for Payer: Healthfirst Commercial	$48,107.00
Rate for Payer: Healthfirst Essential Plan	$76,431.04
Rate for Payer: Healthfirst QHP	$26,916.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,969.35
Rate for Payer: SOMOS Essential	$76,431.04
Rate for Payer: United Healthcare Essential Plan 1&2	$76,431.04
Rate for Payer: United Healthcare Essential Plan 3&4	$76,431.04
Rate for Payer: United Healthcare Medicaid	$33,969.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,969.35

APR-DRG 2234: Other small & large bowel procedures

Facility

$127,754.78

Service Code	APR-DRG 2234
Min. Negotiated Rate	$56,779.90
Max. Negotiated Rate	$127,754.78
Rate for Payer: Affinity Essential Plan 1&2	$127,754.78
Rate for Payer: Affinity Essential Plan 3&4	$127,754.78
Rate for Payer: Affinity Medicaid/CHP/HARP	$56,779.90
Rate for Payer: Amida Care Medicaid	$56,779.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$56,779.90
Rate for Payer: Fidelis Qualified Health Plan	$68,135.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$56,779.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$56,779.90
Rate for Payer: Healthfirst Commercial	$103,966.00
Rate for Payer: Healthfirst Essential Plan	$127,754.78
Rate for Payer: Healthfirst QHP	$63,622.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56,779.90
Rate for Payer: SOMOS Essential	$127,754.78
Rate for Payer: United Healthcare Essential Plan 1&2	$127,754.78
Rate for Payer: United Healthcare Essential Plan 3&4	$127,754.78
Rate for Payer: United Healthcare Medicaid	$56,779.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56,779.90

APR-DRG 2241: Peritoneal adhesiolysis

Facility

$50,779.73

Service Code	APR-DRG 2241
Min. Negotiated Rate	$14,484.00
Max. Negotiated Rate	$50,779.73
Rate for Payer: Affinity Essential Plan 1&2	$50,779.73
Rate for Payer: Affinity Essential Plan 3&4	$50,779.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,568.77
Rate for Payer: Amida Care Medicaid	$22,568.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,568.77
Rate for Payer: Fidelis Qualified Health Plan	$27,082.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,568.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,568.77
Rate for Payer: Healthfirst Commercial	$24,015.00
Rate for Payer: Healthfirst Essential Plan	$50,779.73
Rate for Payer: Healthfirst QHP	$14,484.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,568.77
Rate for Payer: SOMOS Essential	$50,779.73
Rate for Payer: United Healthcare Essential Plan 1&2	$50,779.73
Rate for Payer: United Healthcare Essential Plan 3&4	$50,779.73
Rate for Payer: United Healthcare Medicaid	$22,568.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,568.77

APR-DRG 2242: Peritoneal adhesiolysis

Facility

$57,805.92

Service Code	APR-DRG 2242
Min. Negotiated Rate	$18,414.00
Max. Negotiated Rate	$57,805.92
Rate for Payer: Affinity Essential Plan 1&2	$57,805.92
Rate for Payer: Affinity Essential Plan 3&4	$57,805.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,691.52
Rate for Payer: Amida Care Medicaid	$25,691.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,691.52
Rate for Payer: Fidelis Qualified Health Plan	$30,829.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,691.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,691.52
Rate for Payer: Healthfirst Commercial	$31,106.00
Rate for Payer: Healthfirst Essential Plan	$57,805.92
Rate for Payer: Healthfirst QHP	$18,414.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,691.52
Rate for Payer: SOMOS Essential	$57,805.92
Rate for Payer: United Healthcare Essential Plan 1&2	$57,805.92
Rate for Payer: United Healthcare Essential Plan 3&4	$57,805.92
Rate for Payer: United Healthcare Medicaid	$25,691.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,691.52

APR-DRG 2243: Peritoneal adhesiolysis

Facility

$76,316.74

Service Code	APR-DRG 2243
Min. Negotiated Rate	$29,505.00
Max. Negotiated Rate	$76,316.74
Rate for Payer: Affinity Essential Plan 1&2	$76,316.74
Rate for Payer: Affinity Essential Plan 3&4	$76,316.74
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,918.55
Rate for Payer: Amida Care Medicaid	$33,918.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,918.55
Rate for Payer: Fidelis Qualified Health Plan	$40,702.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,918.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,918.55
Rate for Payer: Healthfirst Commercial	$51,110.00
Rate for Payer: Healthfirst Essential Plan	$76,316.74
Rate for Payer: Healthfirst QHP	$29,505.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,918.55
Rate for Payer: SOMOS Essential	$76,316.74
Rate for Payer: United Healthcare Essential Plan 1&2	$76,316.74
Rate for Payer: United Healthcare Essential Plan 3&4	$76,316.74
Rate for Payer: United Healthcare Medicaid	$33,918.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,918.55

APR-DRG 2244: Peritoneal adhesiolysis

Facility

$127,580.67

Service Code	APR-DRG 2244
Min. Negotiated Rate	$48,656.00
Max. Negotiated Rate	$127,580.67
Rate for Payer: Affinity Essential Plan 1&2	$127,580.67
Rate for Payer: Affinity Essential Plan 3&4	$127,580.67
Rate for Payer: Affinity Medicaid/CHP/HARP	$56,702.52
Rate for Payer: Amida Care Medicaid	$56,702.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$56,702.52
Rate for Payer: Fidelis Qualified Health Plan	$68,043.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$56,702.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$56,702.52
Rate for Payer: Healthfirst Commercial	$77,179.00
Rate for Payer: Healthfirst Essential Plan	$127,580.67
Rate for Payer: Healthfirst QHP	$48,656.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56,702.52
Rate for Payer: SOMOS Essential	$127,580.67
Rate for Payer: United Healthcare Essential Plan 1&2	$127,580.67
Rate for Payer: United Healthcare Essential Plan 3&4	$127,580.67
Rate for Payer: United Healthcare Medicaid	$56,702.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56,702.52

APR-DRG 2251: Appendectomy

Facility

$42,306.10

Service Code	APR-DRG 2251
Min. Negotiated Rate	$8,044.00
Max. Negotiated Rate	$42,306.10
Rate for Payer: Affinity Essential Plan 1&2	$42,306.10
Rate for Payer: Affinity Essential Plan 3&4	$42,306.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,802.71
Rate for Payer: Amida Care Medicaid	$18,802.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,802.71
Rate for Payer: Fidelis Qualified Health Plan	$22,563.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,802.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,802.71
Rate for Payer: Healthfirst Commercial	$13,544.00
Rate for Payer: Healthfirst Essential Plan	$42,306.10
Rate for Payer: Healthfirst QHP	$8,044.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,802.71
Rate for Payer: SOMOS Essential	$42,306.10
Rate for Payer: United Healthcare Essential Plan 1&2	$42,306.10
Rate for Payer: United Healthcare Essential Plan 3&4	$42,306.10
Rate for Payer: United Healthcare Medicaid	$18,802.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,802.71

APR-DRG 2252: Appendectomy

Facility

$49,066.72

Service Code	APR-DRG 2252
Min. Negotiated Rate	$11,174.00
Max. Negotiated Rate	$49,066.72
Rate for Payer: Affinity Essential Plan 1&2	$49,066.72
Rate for Payer: Affinity Essential Plan 3&4	$49,066.72
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,807.43
Rate for Payer: Amida Care Medicaid	$21,807.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,807.43
Rate for Payer: Fidelis Qualified Health Plan	$26,168.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,807.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,807.43
Rate for Payer: Healthfirst Commercial	$19,202.00
Rate for Payer: Healthfirst Essential Plan	$49,066.72
Rate for Payer: Healthfirst QHP	$11,174.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,807.43
Rate for Payer: SOMOS Essential	$49,066.72
Rate for Payer: United Healthcare Essential Plan 1&2	$49,066.72
Rate for Payer: United Healthcare Essential Plan 3&4	$49,066.72
Rate for Payer: United Healthcare Medicaid	$21,807.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,807.43

APR-DRG 2253: Appendectomy

Facility

$65,324.56

Service Code	APR-DRG 2253
Min. Negotiated Rate	$18,937.00
Max. Negotiated Rate	$65,324.56
Rate for Payer: Affinity Essential Plan 1&2	$65,324.56
Rate for Payer: Affinity Essential Plan 3&4	$65,324.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,033.14
Rate for Payer: Amida Care Medicaid	$29,033.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,033.14
Rate for Payer: Fidelis Qualified Health Plan	$34,839.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,033.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,033.14
Rate for Payer: Healthfirst Commercial	$32,838.00
Rate for Payer: Healthfirst Essential Plan	$65,324.56
Rate for Payer: Healthfirst QHP	$18,937.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,033.14
Rate for Payer: SOMOS Essential	$65,324.56
Rate for Payer: United Healthcare Essential Plan 1&2	$65,324.56
Rate for Payer: United Healthcare Essential Plan 3&4	$65,324.56
Rate for Payer: United Healthcare Medicaid	$29,033.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,033.14

APR-DRG 2254: Appendectomy

Facility

$101,086.92

Service Code	APR-DRG 2254
Min. Negotiated Rate	$37,143.00
Max. Negotiated Rate	$101,086.92
Rate for Payer: Affinity Essential Plan 1&2	$101,086.92
Rate for Payer: Affinity Essential Plan 3&4	$101,086.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$44,927.52
Rate for Payer: Amida Care Medicaid	$44,927.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$44,927.52
Rate for Payer: Fidelis Qualified Health Plan	$53,913.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$44,927.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$44,927.52
Rate for Payer: Healthfirst Commercial	$71,681.00
Rate for Payer: Healthfirst Essential Plan	$101,086.92
Rate for Payer: Healthfirst QHP	$37,143.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$44,927.52
Rate for Payer: SOMOS Essential	$101,086.92
Rate for Payer: United Healthcare Essential Plan 1&2	$101,086.92
Rate for Payer: United Healthcare Essential Plan 3&4	$101,086.92
Rate for Payer: United Healthcare Medicaid	$44,927.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$44,927.52

APR-DRG 2261: Anal procedures

Facility

$40,527.99

Service Code	APR-DRG 2261
Min. Negotiated Rate	$7,058.00
Max. Negotiated Rate	$40,527.99
Rate for Payer: Affinity Essential Plan 1&2	$40,527.99
Rate for Payer: Affinity Essential Plan 3&4	$40,527.99
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,012.44
Rate for Payer: Amida Care Medicaid	$18,012.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,012.44
Rate for Payer: Fidelis Qualified Health Plan	$21,614.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,012.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,012.44
Rate for Payer: Healthfirst Commercial	$12,262.00
Rate for Payer: Healthfirst Essential Plan	$40,527.99
Rate for Payer: Healthfirst QHP	$7,058.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,012.44
Rate for Payer: SOMOS Essential	$40,527.99
Rate for Payer: United Healthcare Essential Plan 1&2	$40,527.99
Rate for Payer: United Healthcare Essential Plan 3&4	$40,527.99
Rate for Payer: United Healthcare Medicaid	$18,012.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,012.44

APR-DRG 2262: Anal procedures

Facility

$45,172.84

Service Code	APR-DRG 2262
Min. Negotiated Rate	$9,020.00
Max. Negotiated Rate	$45,172.84
Rate for Payer: Affinity Essential Plan 1&2	$45,172.84
Rate for Payer: Affinity Essential Plan 3&4	$45,172.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,076.82
Rate for Payer: Amida Care Medicaid	$20,076.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,076.82
Rate for Payer: Fidelis Qualified Health Plan	$24,092.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,076.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,076.82
Rate for Payer: Healthfirst Commercial	$16,654.00
Rate for Payer: Healthfirst Essential Plan	$45,172.84
Rate for Payer: Healthfirst QHP	$9,020.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,076.82
Rate for Payer: SOMOS Essential	$45,172.84
Rate for Payer: United Healthcare Essential Plan 1&2	$45,172.84
Rate for Payer: United Healthcare Essential Plan 3&4	$45,172.84
Rate for Payer: United Healthcare Medicaid	$20,076.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,076.82

APR-DRG 2263: Anal procedures

Facility

$55,996.18

Service Code	APR-DRG 2263
Min. Negotiated Rate	$16,652.00
Max. Negotiated Rate	$55,996.18
Rate for Payer: Affinity Essential Plan 1&2	$55,996.18
Rate for Payer: Affinity Essential Plan 3&4	$55,996.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,887.19
Rate for Payer: Amida Care Medicaid	$24,887.19
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,887.19
Rate for Payer: Fidelis Qualified Health Plan	$29,864.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,887.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,887.19
Rate for Payer: Healthfirst Commercial	$29,389.00
Rate for Payer: Healthfirst Essential Plan	$55,996.18
Rate for Payer: Healthfirst QHP	$16,652.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,887.19
Rate for Payer: SOMOS Essential	$55,996.18
Rate for Payer: United Healthcare Essential Plan 1&2	$55,996.18
Rate for Payer: United Healthcare Essential Plan 3&4	$55,996.18
Rate for Payer: United Healthcare Medicaid	$24,887.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,887.19

APR-DRG 2264: Anal procedures

Facility

$93,466.26

Service Code	APR-DRG 2264
Min. Negotiated Rate	$17,265.00
Max. Negotiated Rate	$93,466.26
Rate for Payer: Affinity Essential Plan 1&2	$93,466.26
Rate for Payer: Affinity Essential Plan 3&4	$93,466.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$41,540.56
Rate for Payer: Amida Care Medicaid	$41,540.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$41,540.56
Rate for Payer: Fidelis Qualified Health Plan	$49,848.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$41,540.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41,540.56
Rate for Payer: Healthfirst Commercial	$36,064.00
Rate for Payer: Healthfirst Essential Plan	$93,466.26
Rate for Payer: Healthfirst QHP	$17,265.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41,540.56
Rate for Payer: SOMOS Essential	$93,466.26
Rate for Payer: United Healthcare Essential Plan 1&2	$93,466.26
Rate for Payer: United Healthcare Essential Plan 3&4	$93,466.26
Rate for Payer: United Healthcare Medicaid	$41,540.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$41,540.56

APR-DRG 2271: Hernia procedures except inguinal, femoral & umbilical

Facility

$47,923.54

Service Code	APR-DRG 2271
Min. Negotiated Rate	$11,678.00
Max. Negotiated Rate	$47,923.54
Rate for Payer: Affinity Essential Plan 1&2	$47,923.54
Rate for Payer: Affinity Essential Plan 3&4	$47,923.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,299.35
Rate for Payer: Amida Care Medicaid	$21,299.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,299.35
Rate for Payer: Fidelis Qualified Health Plan	$25,559.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,299.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,299.35
Rate for Payer: Healthfirst Commercial	$20,069.00
Rate for Payer: Healthfirst Essential Plan	$47,923.54
Rate for Payer: Healthfirst QHP	$11,678.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,299.35
Rate for Payer: SOMOS Essential	$47,923.54
Rate for Payer: United Healthcare Essential Plan 1&2	$47,923.54
Rate for Payer: United Healthcare Essential Plan 3&4	$47,923.54
Rate for Payer: United Healthcare Medicaid	$21,299.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,299.35

APR-DRG 2272: Hernia procedures except inguinal, femoral & umbilical

Facility

$53,393.22

Service Code	APR-DRG 2272
Min. Negotiated Rate	$15,095.00
Max. Negotiated Rate	$53,393.22
Rate for Payer: Affinity Essential Plan 1&2	$53,393.22
Rate for Payer: Affinity Essential Plan 3&4	$53,393.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,730.32
Rate for Payer: Amida Care Medicaid	$23,730.32
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,730.32
Rate for Payer: Fidelis Qualified Health Plan	$28,476.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,730.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,730.32
Rate for Payer: Healthfirst Commercial	$25,641.00
Rate for Payer: Healthfirst Essential Plan	$53,393.22
Rate for Payer: Healthfirst QHP	$15,095.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,730.32
Rate for Payer: SOMOS Essential	$53,393.22
Rate for Payer: United Healthcare Essential Plan 1&2	$53,393.22
Rate for Payer: United Healthcare Essential Plan 3&4	$53,393.22
Rate for Payer: United Healthcare Medicaid	$23,730.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,730.32

APR-DRG 2273: Hernia procedures except inguinal, femoral & umbilical

Facility

$70,417.89

Service Code	APR-DRG 2273
Min. Negotiated Rate	$24,963.00
Max. Negotiated Rate	$70,417.89
Rate for Payer: Affinity Essential Plan 1&2	$70,417.89
Rate for Payer: Affinity Essential Plan 3&4	$70,417.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$31,296.84
Rate for Payer: Amida Care Medicaid	$31,296.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,296.84
Rate for Payer: Fidelis Qualified Health Plan	$37,556.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,296.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,296.84
Rate for Payer: Healthfirst Commercial	$45,021.00
Rate for Payer: Healthfirst Essential Plan	$70,417.89
Rate for Payer: Healthfirst QHP	$24,963.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,296.84
Rate for Payer: SOMOS Essential	$70,417.89
Rate for Payer: United Healthcare Essential Plan 1&2	$70,417.89
Rate for Payer: United Healthcare Essential Plan 3&4	$70,417.89
Rate for Payer: United Healthcare Medicaid	$31,296.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,296.84

APR-DRG 2274: Hernia procedures except inguinal, femoral & umbilical

Facility

$122,394.13

Service Code	APR-DRG 2274
Min. Negotiated Rate	$54,397.39
Max. Negotiated Rate	$122,394.13
Rate for Payer: Affinity Essential Plan 1&2	$122,394.13
Rate for Payer: Affinity Essential Plan 3&4	$122,394.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$54,397.39
Rate for Payer: Amida Care Medicaid	$54,397.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54,397.39
Rate for Payer: Fidelis Qualified Health Plan	$65,276.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$54,397.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54,397.39
Rate for Payer: Healthfirst Commercial	$96,069.00
Rate for Payer: Healthfirst Essential Plan	$122,394.13
Rate for Payer: Healthfirst QHP	$57,796.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54,397.39
Rate for Payer: SOMOS Essential	$122,394.13
Rate for Payer: United Healthcare Essential Plan 1&2	$122,394.13
Rate for Payer: United Healthcare Essential Plan 3&4	$122,394.13
Rate for Payer: United Healthcare Medicaid	$54,397.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$54,397.39

APR-DRG 2281: Inguinal, femoral & umbilical hernia procedures

Facility

$41,905.10

Service Code	APR-DRG 2281
Min. Negotiated Rate	$7,650.00
Max. Negotiated Rate	$41,905.10
Rate for Payer: Affinity Essential Plan 1&2	$41,905.10
Rate for Payer: Affinity Essential Plan 3&4	$41,905.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,624.49
Rate for Payer: Amida Care Medicaid	$18,624.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,624.49
Rate for Payer: Fidelis Qualified Health Plan	$22,349.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,624.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,624.49
Rate for Payer: Healthfirst Commercial	$13,071.00
Rate for Payer: Healthfirst Essential Plan	$41,905.10
Rate for Payer: Healthfirst QHP	$7,650.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,624.49
Rate for Payer: SOMOS Essential	$41,905.10
Rate for Payer: United Healthcare Essential Plan 1&2	$41,905.10
Rate for Payer: United Healthcare Essential Plan 3&4	$41,905.10
Rate for Payer: United Healthcare Medicaid	$18,624.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,624.49

APR-DRG 2282: Inguinal, femoral & umbilical hernia procedures

Facility

$46,409.24

Service Code	APR-DRG 2282
Min. Negotiated Rate	$10,012.00
Max. Negotiated Rate	$46,409.24
Rate for Payer: Affinity Essential Plan 1&2	$46,409.24
Rate for Payer: Affinity Essential Plan 3&4	$46,409.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,626.33
Rate for Payer: Amida Care Medicaid	$20,626.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,626.33
Rate for Payer: Fidelis Qualified Health Plan	$24,751.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,626.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,626.33
Rate for Payer: Healthfirst Commercial	$17,511.00
Rate for Payer: Healthfirst Essential Plan	$46,409.24
Rate for Payer: Healthfirst QHP	$10,012.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,626.33
Rate for Payer: SOMOS Essential	$46,409.24
Rate for Payer: United Healthcare Essential Plan 1&2	$46,409.24
Rate for Payer: United Healthcare Essential Plan 3&4	$46,409.24
Rate for Payer: United Healthcare Medicaid	$20,626.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,626.33

APR-DRG 2283: Inguinal, femoral & umbilical hernia procedures

Facility

$58,022.26

Service Code	APR-DRG 2283
Min. Negotiated Rate	$15,762.00
Max. Negotiated Rate	$58,022.26
Rate for Payer: Affinity Essential Plan 1&2	$58,022.26
Rate for Payer: Affinity Essential Plan 3&4	$58,022.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,787.67
Rate for Payer: Amida Care Medicaid	$25,787.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,787.67
Rate for Payer: Fidelis Qualified Health Plan	$30,945.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,787.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,787.67
Rate for Payer: Healthfirst Commercial	$29,163.00
Rate for Payer: Healthfirst Essential Plan	$58,022.26
Rate for Payer: Healthfirst QHP	$15,762.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,787.67
Rate for Payer: SOMOS Essential	$58,022.26
Rate for Payer: United Healthcare Essential Plan 1&2	$58,022.26
Rate for Payer: United Healthcare Essential Plan 3&4	$58,022.26
Rate for Payer: United Healthcare Medicaid	$25,787.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,787.67

APR-DRG 2284: Inguinal, femoral & umbilical hernia procedures

Facility

$108,009.34

Service Code	APR-DRG 2284
Min. Negotiated Rate	$35,101.00
Max. Negotiated Rate	$108,009.34
Rate for Payer: Affinity Essential Plan 1&2	$108,009.34
Rate for Payer: Affinity Essential Plan 3&4	$108,009.34
Rate for Payer: Affinity Medicaid/CHP/HARP	$48,004.15
Rate for Payer: Amida Care Medicaid	$48,004.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$48,004.15
Rate for Payer: Fidelis Qualified Health Plan	$57,604.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$48,004.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$48,004.15
Rate for Payer: Healthfirst Commercial	$69,294.00
Rate for Payer: Healthfirst Essential Plan	$108,009.34
Rate for Payer: Healthfirst QHP	$35,101.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48,004.15
Rate for Payer: SOMOS Essential	$108,009.34
Rate for Payer: United Healthcare Essential Plan 1&2	$108,009.34
Rate for Payer: United Healthcare Essential Plan 3&4	$108,009.34
Rate for Payer: United Healthcare Medicaid	$48,004.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48,004.15

APR-DRG 2291: Other digestive system & abdominal procedures

Facility

$47,605.18

Service Code	APR-DRG 2291
Min. Negotiated Rate	$12,328.00
Max. Negotiated Rate	$47,605.18
Rate for Payer: Affinity Essential Plan 1&2	$47,605.18
Rate for Payer: Affinity Essential Plan 3&4	$47,605.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,157.86
Rate for Payer: Amida Care Medicaid	$21,157.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,157.86
Rate for Payer: Fidelis Qualified Health Plan	$25,389.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,157.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,157.86
Rate for Payer: Healthfirst Commercial	$21,206.00
Rate for Payer: Healthfirst Essential Plan	$47,605.18
Rate for Payer: Healthfirst QHP	$12,328.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,157.86
Rate for Payer: SOMOS Essential	$47,605.18
Rate for Payer: United Healthcare Essential Plan 1&2	$47,605.18
Rate for Payer: United Healthcare Essential Plan 3&4	$47,605.18
Rate for Payer: United Healthcare Medicaid	$21,157.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,157.86

APR-DRG 2292: Other digestive system & abdominal procedures

Facility

$55,676.09

Service Code	APR-DRG 2292
Min. Negotiated Rate	$18,212.00
Max. Negotiated Rate	$55,676.09
Rate for Payer: Affinity Essential Plan 1&2	$55,676.09
Rate for Payer: Affinity Essential Plan 3&4	$55,676.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,744.93
Rate for Payer: Amida Care Medicaid	$24,744.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,744.93
Rate for Payer: Fidelis Qualified Health Plan	$29,693.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,744.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,744.93
Rate for Payer: Healthfirst Commercial	$29,226.00
Rate for Payer: Healthfirst Essential Plan	$55,676.09
Rate for Payer: Healthfirst QHP	$18,212.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,744.93
Rate for Payer: SOMOS Essential	$55,676.09
Rate for Payer: United Healthcare Essential Plan 1&2	$55,676.09
Rate for Payer: United Healthcare Essential Plan 3&4	$55,676.09
Rate for Payer: United Healthcare Medicaid	$24,744.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,744.93

APR-DRG 2293: Other digestive system & abdominal procedures

Facility

$75,470.76

Service Code	APR-DRG 2293
Min. Negotiated Rate	$30,371.00
Max. Negotiated Rate	$75,470.76
Rate for Payer: Affinity Essential Plan 1&2	$75,470.76
Rate for Payer: Affinity Essential Plan 3&4	$75,470.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,542.56
Rate for Payer: Amida Care Medicaid	$33,542.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,542.56
Rate for Payer: Fidelis Qualified Health Plan	$40,251.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,542.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,542.56
Rate for Payer: Healthfirst Commercial	$51,117.00
Rate for Payer: Healthfirst Essential Plan	$75,470.76
Rate for Payer: Healthfirst QHP	$30,371.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,542.56
Rate for Payer: SOMOS Essential	$75,470.76
Rate for Payer: United Healthcare Essential Plan 1&2	$75,470.76
Rate for Payer: United Healthcare Essential Plan 3&4	$75,470.76
Rate for Payer: United Healthcare Medicaid	$33,542.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,542.56

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