St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 7221: Fever

Facility IP

$38,672.53

Service Code	APR-DRG 7221
Min. Negotiated Rate	$5,549.00
Max. Negotiated Rate	$38,672.53
Rate for Payer: Amida Care Medicaid	$17,187.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,187.79
Rate for Payer: Fidelis Qualified Health Plan	$20,625.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,187.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,187.79
Rate for Payer: Healthfirst Commercial	$9,937.00
Rate for Payer: Healthfirst Essential Plan	$38,672.53
Rate for Payer: Healthfirst QHP	$5,549.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,187.79
Rate for Payer: SOMOS Essential	$38,672.53
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,187.79

APR-DRG 7222: Fever

Facility IP

$39,930.03

Service Code	APR-DRG 7222
Min. Negotiated Rate	$6,894.00
Max. Negotiated Rate	$39,930.03
Rate for Payer: Amida Care Medicaid	$17,746.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,746.68
Rate for Payer: Fidelis Qualified Health Plan	$21,296.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,746.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,746.68
Rate for Payer: Healthfirst Commercial	$11,665.00
Rate for Payer: Healthfirst Essential Plan	$39,930.03
Rate for Payer: Healthfirst QHP	$6,894.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,746.68
Rate for Payer: SOMOS Essential	$39,930.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,746.68

APR-DRG 7223: Fever

Facility IP

$44,574.88

Service Code	APR-DRG 7223
Min. Negotiated Rate	$9,387.00
Max. Negotiated Rate	$44,574.88
Rate for Payer: Amida Care Medicaid	$19,811.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,811.06
Rate for Payer: Fidelis Qualified Health Plan	$23,773.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,811.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,811.06
Rate for Payer: Healthfirst Commercial	$16,097.00
Rate for Payer: Healthfirst Essential Plan	$44,574.88
Rate for Payer: Healthfirst QHP	$9,387.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,811.06
Rate for Payer: SOMOS Essential	$44,574.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,811.06

APR-DRG 7224: Fever

Facility IP

$61,159.86

Service Code	APR-DRG 7224
Min. Negotiated Rate	$17,661.00
Max. Negotiated Rate	$61,159.86
Rate for Payer: Amida Care Medicaid	$27,182.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,182.16
Rate for Payer: Fidelis Qualified Health Plan	$32,618.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,182.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,182.16
Rate for Payer: Healthfirst Commercial	$24,361.00
Rate for Payer: Healthfirst Essential Plan	$61,159.86
Rate for Payer: Healthfirst QHP	$17,661.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,182.16
Rate for Payer: SOMOS Essential	$61,159.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,182.16

APR-DRG 7231: Viral illness

Facility IP

$37,729.84

Service Code	APR-DRG 7231
Min. Negotiated Rate	$5,296.00
Max. Negotiated Rate	$37,729.84
Rate for Payer: Amida Care Medicaid	$16,768.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,768.82
Rate for Payer: Fidelis Qualified Health Plan	$20,122.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,768.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,768.82
Rate for Payer: Healthfirst Commercial	$9,208.00
Rate for Payer: Healthfirst Essential Plan	$37,729.84
Rate for Payer: Healthfirst QHP	$5,296.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,768.82
Rate for Payer: SOMOS Essential	$37,729.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,768.82

APR-DRG 7232: Viral illness

Facility IP

$39,411.20

Service Code	APR-DRG 7232
Min. Negotiated Rate	$6,252.00
Max. Negotiated Rate	$39,411.20
Rate for Payer: Amida Care Medicaid	$17,516.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,516.09
Rate for Payer: Fidelis Qualified Health Plan	$21,019.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,516.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,516.09
Rate for Payer: Healthfirst Commercial	$10,708.00
Rate for Payer: Healthfirst Essential Plan	$39,411.20
Rate for Payer: Healthfirst QHP	$6,252.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,516.09
Rate for Payer: SOMOS Essential	$39,411.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,516.09

APR-DRG 7233: Viral illness

Facility IP

$44,669.86

Service Code	APR-DRG 7233
Min. Negotiated Rate	$9,300.00
Max. Negotiated Rate	$44,669.86
Rate for Payer: Amida Care Medicaid	$19,853.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,853.27
Rate for Payer: Fidelis Qualified Health Plan	$23,823.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,853.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,853.27
Rate for Payer: Healthfirst Commercial	$17,095.00
Rate for Payer: Healthfirst Essential Plan	$44,669.86
Rate for Payer: Healthfirst QHP	$9,300.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,853.27
Rate for Payer: SOMOS Essential	$44,669.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,853.27

APR-DRG 7234: Viral illness

Facility IP

$76,912.94

Service Code	APR-DRG 7234
Min. Negotiated Rate	$27,851.00
Max. Negotiated Rate	$76,912.94
Rate for Payer: Amida Care Medicaid	$34,183.53
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,183.53
Rate for Payer: Fidelis Qualified Health Plan	$41,020.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,183.53
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,183.53
Rate for Payer: Healthfirst Commercial	$54,542.00
Rate for Payer: Healthfirst Essential Plan	$76,912.94
Rate for Payer: Healthfirst QHP	$27,851.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,183.53
Rate for Payer: SOMOS Essential	$76,912.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,183.53

APR-DRG 7241: Other infectious & parasitic diseases

Facility IP

$41,006.38

Service Code	APR-DRG 7241
Min. Negotiated Rate	$7,062.00
Max. Negotiated Rate	$41,006.38
Rate for Payer: Amida Care Medicaid	$18,225.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,225.06
Rate for Payer: Fidelis Qualified Health Plan	$21,870.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,225.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,225.06
Rate for Payer: Healthfirst Commercial	$12,468.00
Rate for Payer: Healthfirst Essential Plan	$41,006.38
Rate for Payer: Healthfirst QHP	$7,062.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,225.06
Rate for Payer: SOMOS Essential	$41,006.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,225.06

APR-DRG 7242: Other infectious & parasitic diseases

Facility IP

$43,136.21

Service Code	APR-DRG 7242
Min. Negotiated Rate	$8,447.00
Max. Negotiated Rate	$43,136.21
Rate for Payer: Amida Care Medicaid	$19,171.65
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,171.65
Rate for Payer: Fidelis Qualified Health Plan	$23,005.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,171.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,171.65
Rate for Payer: Healthfirst Commercial	$14,245.00
Rate for Payer: Healthfirst Essential Plan	$43,136.21
Rate for Payer: Healthfirst QHP	$8,447.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,171.65
Rate for Payer: SOMOS Essential	$43,136.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,171.65

APR-DRG 7243: Other infectious & parasitic diseases

Facility IP

$53,613.07

Service Code	APR-DRG 7243
Min. Negotiated Rate	$13,528.00
Max. Negotiated Rate	$53,613.07
Rate for Payer: Amida Care Medicaid	$23,828.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,828.03
Rate for Payer: Fidelis Qualified Health Plan	$28,593.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,828.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,828.03
Rate for Payer: Healthfirst Commercial	$23,343.00
Rate for Payer: Healthfirst Essential Plan	$53,613.07
Rate for Payer: Healthfirst QHP	$13,528.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,828.03
Rate for Payer: SOMOS Essential	$53,613.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,828.03

APR-DRG 7244: Other infectious & parasitic diseases

Facility IP

$93,320.28

Service Code	APR-DRG 7244
Min. Negotiated Rate	$28,211.00
Max. Negotiated Rate	$93,320.28
Rate for Payer: Amida Care Medicaid	$41,475.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$41,475.68
Rate for Payer: Fidelis Qualified Health Plan	$49,770.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$41,475.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41,475.68
Rate for Payer: Healthfirst Commercial	$53,889.00
Rate for Payer: Healthfirst Essential Plan	$93,320.28
Rate for Payer: Healthfirst QHP	$28,211.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41,475.68
Rate for Payer: SOMOS Essential	$93,320.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$41,475.68

APR-DRG 7401: Mental illness diagnosis w O.R. procedure

Facility IP

$28,905.00

Service Code	APR-DRG 7401
Min. Negotiated Rate	$2,342.42
Max. Negotiated Rate	$28,905.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,342.42
Rate for Payer: Fidelis Qualified Health Plan	$2,810.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,342.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,342.42
Rate for Payer: Healthfirst Commercial	$28,905.00
Rate for Payer: Healthfirst Essential Plan	$5,270.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,342.42
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,270.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,270.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.42
Rate for Payer: SOMOS Essential	$5,270.44

APR-DRG 7402: Mental illness diagnosis w O.R. procedure

Facility IP

$28,905.00

Service Code	APR-DRG 7402
Min. Negotiated Rate	$2,342.42
Max. Negotiated Rate	$28,905.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,342.42
Rate for Payer: Fidelis Qualified Health Plan	$2,810.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,342.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,342.42
Rate for Payer: Healthfirst Commercial	$28,905.00
Rate for Payer: Healthfirst Essential Plan	$5,270.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,342.42
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,270.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,270.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.42
Rate for Payer: SOMOS Essential	$5,270.44

APR-DRG 7403: Mental illness diagnosis w O.R. procedure

Facility IP

$28,905.00

Service Code	APR-DRG 7403
Min. Negotiated Rate	$2,342.42
Max. Negotiated Rate	$28,905.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,342.42
Rate for Payer: Fidelis Qualified Health Plan	$2,810.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,342.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,342.42
Rate for Payer: Healthfirst Commercial	$28,905.00
Rate for Payer: Healthfirst Essential Plan	$5,270.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,342.42
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,270.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,270.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.42
Rate for Payer: SOMOS Essential	$5,270.44

APR-DRG 7404: Mental illness diagnosis w O.R. procedure

Facility IP

$28,905.00

Service Code	APR-DRG 7404
Min. Negotiated Rate	$2,342.42
Max. Negotiated Rate	$28,905.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,342.42
Rate for Payer: Fidelis Qualified Health Plan	$2,810.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,342.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,342.42
Rate for Payer: Healthfirst Commercial	$28,905.00
Rate for Payer: Healthfirst Essential Plan	$5,270.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,342.42
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,270.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,270.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.42
Rate for Payer: SOMOS Essential	$5,270.44

APR-DRG 7501: Schizophrenia

Facility IP

$18,936.00

Service Code	APR-DRG 7501
Min. Negotiated Rate	$2,129.25
Max. Negotiated Rate	$18,936.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,129.25
Rate for Payer: Fidelis Qualified Health Plan	$2,555.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,129.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,129.25
Rate for Payer: Healthfirst Commercial	$18,936.00
Rate for Payer: Healthfirst Essential Plan	$4,790.81
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,129.25
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,790.81
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,790.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,129.25
Rate for Payer: SOMOS Essential	$4,790.81

APR-DRG 7502: Schizophrenia

Facility IP

$18,936.00

Service Code	APR-DRG 7502
Min. Negotiated Rate	$2,182.59
Max. Negotiated Rate	$18,936.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,182.59
Rate for Payer: Fidelis Qualified Health Plan	$2,619.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,182.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,182.59
Rate for Payer: Healthfirst Commercial	$18,936.00
Rate for Payer: Healthfirst Essential Plan	$4,910.83
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,182.59
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,910.83
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,910.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,182.59
Rate for Payer: SOMOS Essential	$4,910.83

APR-DRG 7503: Schizophrenia

Facility IP

$18,936.00

Service Code	APR-DRG 7503
Min. Negotiated Rate	$2,246.20
Max. Negotiated Rate	$18,936.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,246.20
Rate for Payer: Fidelis Qualified Health Plan	$2,695.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,246.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,246.20
Rate for Payer: Healthfirst Commercial	$18,936.00
Rate for Payer: Healthfirst Essential Plan	$5,053.95
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,246.20
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,053.95
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,053.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,246.20
Rate for Payer: SOMOS Essential	$5,053.95

APR-DRG 7504: Schizophrenia

Facility IP

$18,936.00

Service Code	APR-DRG 7504
Min. Negotiated Rate	$2,265.21
Max. Negotiated Rate	$18,936.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,265.21
Rate for Payer: Fidelis Qualified Health Plan	$2,718.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,265.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,265.21
Rate for Payer: Healthfirst Commercial	$18,936.00
Rate for Payer: Healthfirst Essential Plan	$5,096.72
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,265.21
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,096.72
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,096.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,265.21
Rate for Payer: SOMOS Essential	$5,096.72

APR-DRG 7511: Major depressive disorders & other/unspecified psychoses

Facility IP

$10,166.00

Service Code	APR-DRG 7511
Min. Negotiated Rate	$2,177.09
Max. Negotiated Rate	$10,166.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,177.09
Rate for Payer: Fidelis Qualified Health Plan	$2,612.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,177.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,177.09
Rate for Payer: Healthfirst Commercial	$10,166.00
Rate for Payer: Healthfirst Essential Plan	$4,898.45
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,177.09
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,898.45
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,898.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,177.09
Rate for Payer: SOMOS Essential	$4,898.45

APR-DRG 7512: Major depressive disorders & other/unspecified psychoses

Facility IP

$11,302.00

Service Code	APR-DRG 7512
Min. Negotiated Rate	$2,242.42
Max. Negotiated Rate	$11,302.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,242.42
Rate for Payer: Fidelis Qualified Health Plan	$2,690.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,242.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,242.42
Rate for Payer: Healthfirst Commercial	$11,302.00
Rate for Payer: Healthfirst Essential Plan	$5,045.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,242.42
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,045.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,045.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,242.42
Rate for Payer: SOMOS Essential	$5,045.44

APR-DRG 7513: Major depressive disorders & other/unspecified psychoses

Facility IP

$24,962.00

Service Code	APR-DRG 7513
Min. Negotiated Rate	$2,261.21
Max. Negotiated Rate	$24,962.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,261.21
Rate for Payer: Fidelis Qualified Health Plan	$2,713.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,261.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,261.21
Rate for Payer: Healthfirst Commercial	$24,962.00
Rate for Payer: Healthfirst Essential Plan	$5,087.72
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,261.21
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,087.72
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,087.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,261.21
Rate for Payer: SOMOS Essential	$5,087.72

APR-DRG 7514: Major depressive disorders & other/unspecified psychoses

Facility IP

$25,517.00

Service Code	APR-DRG 7514
Min. Negotiated Rate	$2,319.75
Max. Negotiated Rate	$25,517.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,319.75
Rate for Payer: Fidelis Qualified Health Plan	$2,783.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,319.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,319.75
Rate for Payer: Healthfirst Commercial	$25,517.00
Rate for Payer: Healthfirst Essential Plan	$5,219.44
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,319.75
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$5,219.44
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$5,219.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,319.75
Rate for Payer: SOMOS Essential	$5,219.44

APR-DRG 7521: Disorders of personality & impulse control

Facility IP

$26,252.00

Service Code	APR-DRG 7521
Min. Negotiated Rate	$2,172.77
Max. Negotiated Rate	$26,252.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,172.77
Rate for Payer: Fidelis Qualified Health Plan	$2,607.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,172.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,172.77
Rate for Payer: Healthfirst Commercial	$26,252.00
Rate for Payer: Healthfirst Essential Plan	$4,888.73
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,172.77
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,888.73
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,888.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,172.77
Rate for Payer: SOMOS Essential	$4,888.73

Price Transparency.

All Charges