St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 2844: Disorders of gallbladder & biliary tract

Facility

$81,775.87

Service Code	APR-DRG 2844
Min. Negotiated Rate	$24,933.00
Max. Negotiated Rate	$81,775.87
Rate for Payer: Affinity Essential Plan 1&2	$81,775.87
Rate for Payer: Affinity Essential Plan 3&4	$81,775.87
Rate for Payer: Affinity Medicaid/CHP/HARP	$36,344.83
Rate for Payer: Amida Care Medicaid	$36,344.83
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,344.83
Rate for Payer: Fidelis Qualified Health Plan	$43,613.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,344.83
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,344.83
Rate for Payer: Healthfirst Commercial	$47,926.00
Rate for Payer: Healthfirst Essential Plan	$81,775.87
Rate for Payer: Healthfirst QHP	$24,933.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,344.83
Rate for Payer: SOMOS Essential	$81,775.87
Rate for Payer: United Healthcare Essential Plan 1&2	$81,775.87
Rate for Payer: United Healthcare Essential Plan 3&4	$81,775.87
Rate for Payer: United Healthcare Medicaid	$36,344.83
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,344.83

APR-DRG 3011: Hip joint replacement

Facility

$62,099.03

Service Code	APR-DRG 3011
Min. Negotiated Rate	$23,799.00
Max. Negotiated Rate	$62,099.03
Rate for Payer: Affinity Essential Plan 1&2	$62,099.03
Rate for Payer: Affinity Essential Plan 3&4	$62,099.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,599.57
Rate for Payer: Amida Care Medicaid	$27,599.57
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,599.57
Rate for Payer: Fidelis Qualified Health Plan	$33,119.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,599.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,599.57
Rate for Payer: Healthfirst Commercial	$37,492.00
Rate for Payer: Healthfirst Essential Plan	$62,099.03
Rate for Payer: Healthfirst QHP	$23,799.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,599.57
Rate for Payer: SOMOS Essential	$62,099.03
Rate for Payer: United Healthcare Essential Plan 1&2	$62,099.03
Rate for Payer: United Healthcare Essential Plan 3&4	$62,099.03
Rate for Payer: United Healthcare Medicaid	$27,599.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,599.57

APR-DRG 3012: Hip joint replacement

Facility

$63,374.11

Service Code	APR-DRG 3012
Min. Negotiated Rate	$24,742.00
Max. Negotiated Rate	$63,374.11
Rate for Payer: Affinity Essential Plan 1&2	$63,374.11
Rate for Payer: Affinity Essential Plan 3&4	$63,374.11
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,166.27
Rate for Payer: Amida Care Medicaid	$28,166.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,166.27
Rate for Payer: Fidelis Qualified Health Plan	$33,799.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,166.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,166.27
Rate for Payer: Healthfirst Commercial	$39,066.00
Rate for Payer: Healthfirst Essential Plan	$63,374.11
Rate for Payer: Healthfirst QHP	$24,742.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,166.27
Rate for Payer: SOMOS Essential	$63,374.11
Rate for Payer: United Healthcare Essential Plan 1&2	$63,374.11
Rate for Payer: United Healthcare Essential Plan 3&4	$63,374.11
Rate for Payer: United Healthcare Medicaid	$28,166.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,166.27

APR-DRG 3013: Hip joint replacement

Facility

$74,257.24

Service Code	APR-DRG 3013
Min. Negotiated Rate	$31,107.00
Max. Negotiated Rate	$74,257.24
Rate for Payer: Affinity Essential Plan 1&2	$74,257.24
Rate for Payer: Affinity Essential Plan 3&4	$74,257.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,003.22
Rate for Payer: Amida Care Medicaid	$33,003.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,003.22
Rate for Payer: Fidelis Qualified Health Plan	$39,603.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,003.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,003.22
Rate for Payer: Healthfirst Commercial	$50,384.00
Rate for Payer: Healthfirst Essential Plan	$74,257.24
Rate for Payer: Healthfirst QHP	$31,107.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,003.22
Rate for Payer: SOMOS Essential	$74,257.24
Rate for Payer: United Healthcare Essential Plan 1&2	$74,257.24
Rate for Payer: United Healthcare Essential Plan 3&4	$74,257.24
Rate for Payer: United Healthcare Medicaid	$33,003.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,003.22

APR-DRG 3014: Hip joint replacement

Facility

$136,112.33

Service Code	APR-DRG 3014
Min. Negotiated Rate	$59,937.00
Max. Negotiated Rate	$136,112.33
Rate for Payer: Affinity Essential Plan 1&2	$136,112.33
Rate for Payer: Affinity Essential Plan 3&4	$136,112.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$60,494.37
Rate for Payer: Amida Care Medicaid	$60,494.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$60,494.37
Rate for Payer: Fidelis Qualified Health Plan	$72,593.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$60,494.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60,494.37
Rate for Payer: Healthfirst Commercial	$96,497.00
Rate for Payer: Healthfirst Essential Plan	$136,112.33
Rate for Payer: Healthfirst QHP	$59,937.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$60,494.37
Rate for Payer: SOMOS Essential	$136,112.33
Rate for Payer: United Healthcare Essential Plan 1&2	$136,112.33
Rate for Payer: United Healthcare Essential Plan 3&4	$136,112.33
Rate for Payer: United Healthcare Medicaid	$60,494.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$60,494.37

APR-DRG 3021: Knee joint replacement

Facility

$60,827.44

Service Code	APR-DRG 3021
Min. Negotiated Rate	$22,164.00
Max. Negotiated Rate	$60,827.44
Rate for Payer: Affinity Essential Plan 1&2	$60,827.44
Rate for Payer: Affinity Essential Plan 3&4	$60,827.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,034.42
Rate for Payer: Amida Care Medicaid	$27,034.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,034.42
Rate for Payer: Fidelis Qualified Health Plan	$32,441.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,034.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,034.42
Rate for Payer: Healthfirst Commercial	$35,147.00
Rate for Payer: Healthfirst Essential Plan	$60,827.44
Rate for Payer: Healthfirst QHP	$22,164.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,034.42
Rate for Payer: SOMOS Essential	$60,827.44
Rate for Payer: United Healthcare Essential Plan 1&2	$60,827.44
Rate for Payer: United Healthcare Essential Plan 3&4	$60,827.44
Rate for Payer: United Healthcare Medicaid	$27,034.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,034.42

APR-DRG 3022: Knee joint replacement

Facility

$64,828.60

Service Code	APR-DRG 3022
Min. Negotiated Rate	$24,310.00
Max. Negotiated Rate	$64,828.60
Rate for Payer: Affinity Essential Plan 1&2	$64,828.60
Rate for Payer: Affinity Essential Plan 3&4	$64,828.60
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,812.71
Rate for Payer: Amida Care Medicaid	$28,812.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,812.71
Rate for Payer: Fidelis Qualified Health Plan	$34,575.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,812.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,812.71
Rate for Payer: Healthfirst Commercial	$38,821.00
Rate for Payer: Healthfirst Essential Plan	$64,828.60
Rate for Payer: Healthfirst QHP	$24,310.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,812.71
Rate for Payer: SOMOS Essential	$64,828.60
Rate for Payer: United Healthcare Essential Plan 1&2	$64,828.60
Rate for Payer: United Healthcare Essential Plan 3&4	$64,828.60
Rate for Payer: United Healthcare Medicaid	$28,812.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,812.71

APR-DRG 3023: Knee joint replacement

Facility

$77,016.71

Service Code	APR-DRG 3023
Min. Negotiated Rate	$29,855.00
Max. Negotiated Rate	$77,016.71
Rate for Payer: Affinity Essential Plan 1&2	$77,016.71
Rate for Payer: Affinity Essential Plan 3&4	$77,016.71
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,229.65
Rate for Payer: Amida Care Medicaid	$34,229.65
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,229.65
Rate for Payer: Fidelis Qualified Health Plan	$41,075.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,229.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,229.65
Rate for Payer: Healthfirst Commercial	$49,462.00
Rate for Payer: Healthfirst Essential Plan	$77,016.71
Rate for Payer: Healthfirst QHP	$29,855.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,229.65
Rate for Payer: SOMOS Essential	$77,016.71
Rate for Payer: United Healthcare Essential Plan 1&2	$77,016.71
Rate for Payer: United Healthcare Essential Plan 3&4	$77,016.71
Rate for Payer: United Healthcare Medicaid	$34,229.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,229.65

APR-DRG 3024: Knee joint replacement

Facility

$125,368.16

Service Code	APR-DRG 3024
Min. Negotiated Rate	$55,631.00
Max. Negotiated Rate	$125,368.16
Rate for Payer: Affinity Essential Plan 1&2	$125,368.16
Rate for Payer: Affinity Essential Plan 3&4	$125,368.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$55,719.18
Rate for Payer: Amida Care Medicaid	$55,719.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$55,719.18
Rate for Payer: Fidelis Qualified Health Plan	$66,863.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$55,719.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$55,719.18
Rate for Payer: Healthfirst Commercial	$105,227.00
Rate for Payer: Healthfirst Essential Plan	$125,368.16
Rate for Payer: Healthfirst QHP	$55,631.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55,719.18
Rate for Payer: SOMOS Essential	$125,368.16
Rate for Payer: United Healthcare Essential Plan 1&2	$125,368.16
Rate for Payer: United Healthcare Essential Plan 3&4	$125,368.16
Rate for Payer: United Healthcare Medicaid	$55,719.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$55,719.18

APR-DRG 3031: Dorsal & lumbar fusion proc for curvature of back

Facility

$107,376.19

Service Code	APR-DRG 3031
Min. Negotiated Rate	$47,722.75
Max. Negotiated Rate	$107,376.19
Rate for Payer: Affinity Essential Plan 1&2	$107,376.19
Rate for Payer: Affinity Essential Plan 3&4	$107,376.19
Rate for Payer: Affinity Medicaid/CHP/HARP	$47,722.75
Rate for Payer: Amida Care Medicaid	$47,722.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$47,722.75
Rate for Payer: Fidelis Qualified Health Plan	$57,267.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$47,722.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$47,722.75
Rate for Payer: Healthfirst Commercial	$75,039.00
Rate for Payer: Healthfirst Essential Plan	$107,376.19
Rate for Payer: Healthfirst QHP	$50,242.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47,722.75
Rate for Payer: SOMOS Essential	$107,376.19
Rate for Payer: United Healthcare Essential Plan 1&2	$107,376.19
Rate for Payer: United Healthcare Essential Plan 3&4	$107,376.19
Rate for Payer: United Healthcare Medicaid	$47,722.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$47,722.75

APR-DRG 3032: Dorsal & lumbar fusion proc for curvature of back

Facility

$122,652.65

Service Code	APR-DRG 3032
Min. Negotiated Rate	$54,512.29
Max. Negotiated Rate	$122,652.65
Rate for Payer: Affinity Essential Plan 1&2	$122,652.65
Rate for Payer: Affinity Essential Plan 3&4	$122,652.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$54,512.29
Rate for Payer: Amida Care Medicaid	$54,512.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54,512.29
Rate for Payer: Fidelis Qualified Health Plan	$65,414.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$54,512.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54,512.29
Rate for Payer: Healthfirst Commercial	$87,832.00
Rate for Payer: Healthfirst Essential Plan	$122,652.65
Rate for Payer: Healthfirst QHP	$57,946.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54,512.29
Rate for Payer: SOMOS Essential	$122,652.65
Rate for Payer: United Healthcare Essential Plan 1&2	$122,652.65
Rate for Payer: United Healthcare Essential Plan 3&4	$122,652.65
Rate for Payer: United Healthcare Medicaid	$54,512.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$54,512.29

APR-DRG 3033: Dorsal & lumbar fusion proc for curvature of back

Facility

$152,544.31

Service Code	APR-DRG 3033
Min. Negotiated Rate	$67,797.47
Max. Negotiated Rate	$152,544.31
Rate for Payer: Affinity Essential Plan 1&2	$152,544.31
Rate for Payer: Affinity Essential Plan 3&4	$152,544.31
Rate for Payer: Affinity Medicaid/CHP/HARP	$67,797.47
Rate for Payer: Amida Care Medicaid	$67,797.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$67,797.47
Rate for Payer: Fidelis Qualified Health Plan	$81,356.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$67,797.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$67,797.47
Rate for Payer: Healthfirst Commercial	$116,372.00
Rate for Payer: Healthfirst Essential Plan	$152,544.31
Rate for Payer: Healthfirst QHP	$77,320.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$67,797.47
Rate for Payer: SOMOS Essential	$152,544.31
Rate for Payer: United Healthcare Essential Plan 1&2	$152,544.31
Rate for Payer: United Healthcare Essential Plan 3&4	$152,544.31
Rate for Payer: United Healthcare Medicaid	$67,797.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$67,797.47

APR-DRG 3034: Dorsal & lumbar fusion proc for curvature of back

Facility

$221,249.72

Service Code	APR-DRG 3034
Min. Negotiated Rate	$98,333.21
Max. Negotiated Rate	$221,249.72
Rate for Payer: Affinity Essential Plan 1&2	$221,249.72
Rate for Payer: Affinity Essential Plan 3&4	$221,249.72
Rate for Payer: Affinity Medicaid/CHP/HARP	$98,333.21
Rate for Payer: Amida Care Medicaid	$98,333.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$98,333.21
Rate for Payer: Fidelis Qualified Health Plan	$117,999.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$98,333.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$98,333.21
Rate for Payer: Healthfirst Commercial	$188,109.00
Rate for Payer: Healthfirst Essential Plan	$221,249.72
Rate for Payer: Healthfirst QHP	$125,866.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$98,333.21
Rate for Payer: SOMOS Essential	$221,249.72
Rate for Payer: United Healthcare Essential Plan 1&2	$221,249.72
Rate for Payer: United Healthcare Essential Plan 3&4	$221,249.72
Rate for Payer: United Healthcare Medicaid	$98,333.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$98,333.21

APR-DRG 3041: Dorsal & lumbar fusion proc except for curvature of back

Facility

$83,568.04

Service Code	APR-DRG 3041
Min. Negotiated Rate	$34,725.00
Max. Negotiated Rate	$83,568.04
Rate for Payer: Affinity Essential Plan 1&2	$83,568.04
Rate for Payer: Affinity Essential Plan 3&4	$83,568.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$37,141.35
Rate for Payer: Amida Care Medicaid	$37,141.35
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,141.35
Rate for Payer: Fidelis Qualified Health Plan	$44,569.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,141.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,141.35
Rate for Payer: Healthfirst Commercial	$57,533.00
Rate for Payer: Healthfirst Essential Plan	$83,568.04
Rate for Payer: Healthfirst QHP	$34,725.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,141.35
Rate for Payer: SOMOS Essential	$83,568.04
Rate for Payer: United Healthcare Essential Plan 1&2	$83,568.04
Rate for Payer: United Healthcare Essential Plan 3&4	$83,568.04
Rate for Payer: United Healthcare Medicaid	$37,141.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,141.35

APR-DRG 3042: Dorsal & lumbar fusion proc except for curvature of back

Facility

$95,328.76

Service Code	APR-DRG 3042
Min. Negotiated Rate	$41,306.00
Max. Negotiated Rate	$95,328.76
Rate for Payer: Affinity Essential Plan 1&2	$95,328.76
Rate for Payer: Affinity Essential Plan 3&4	$95,328.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$42,368.34
Rate for Payer: Amida Care Medicaid	$42,368.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$42,368.34
Rate for Payer: Fidelis Qualified Health Plan	$50,842.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$42,368.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42,368.34
Rate for Payer: Healthfirst Commercial	$68,861.00
Rate for Payer: Healthfirst Essential Plan	$95,328.76
Rate for Payer: Healthfirst QHP	$41,306.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42,368.34
Rate for Payer: SOMOS Essential	$95,328.76
Rate for Payer: United Healthcare Essential Plan 1&2	$95,328.76
Rate for Payer: United Healthcare Essential Plan 3&4	$95,328.76
Rate for Payer: United Healthcare Medicaid	$42,368.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$42,368.34

APR-DRG 3043: Dorsal & lumbar fusion proc except for curvature of back

Facility

$123,342.08

Service Code	APR-DRG 3043
Min. Negotiated Rate	$54,818.70
Max. Negotiated Rate	$123,342.08
Rate for Payer: Affinity Essential Plan 1&2	$123,342.08
Rate for Payer: Affinity Essential Plan 3&4	$123,342.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$54,818.70
Rate for Payer: Amida Care Medicaid	$54,818.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54,818.70
Rate for Payer: Fidelis Qualified Health Plan	$65,782.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$54,818.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54,818.70
Rate for Payer: Healthfirst Commercial	$95,106.00
Rate for Payer: Healthfirst Essential Plan	$123,342.08
Rate for Payer: Healthfirst QHP	$59,751.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54,818.70
Rate for Payer: SOMOS Essential	$123,342.08
Rate for Payer: United Healthcare Essential Plan 1&2	$123,342.08
Rate for Payer: United Healthcare Essential Plan 3&4	$123,342.08
Rate for Payer: United Healthcare Medicaid	$54,818.70
Rate for Payer: Wellcare CHP/FHP/Medicaid	$54,818.70

APR-DRG 3044: Dorsal & lumbar fusion proc except for curvature of back

Facility

$191,134.71

Service Code	APR-DRG 3044
Min. Negotiated Rate	$84,948.76
Max. Negotiated Rate	$191,134.71
Rate for Payer: Affinity Essential Plan 1&2	$191,134.71
Rate for Payer: Affinity Essential Plan 3&4	$191,134.71
Rate for Payer: Affinity Medicaid/CHP/HARP	$84,948.76
Rate for Payer: Amida Care Medicaid	$84,948.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$84,948.76
Rate for Payer: Fidelis Qualified Health Plan	$101,938.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$84,948.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$84,948.76
Rate for Payer: Healthfirst Commercial	$165,461.00
Rate for Payer: Healthfirst Essential Plan	$191,134.71
Rate for Payer: Healthfirst QHP	$104,376.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$84,948.76
Rate for Payer: SOMOS Essential	$191,134.71
Rate for Payer: United Healthcare Essential Plan 1&2	$191,134.71
Rate for Payer: United Healthcare Essential Plan 3&4	$191,134.71
Rate for Payer: United Healthcare Medicaid	$84,948.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$84,948.76

APR-DRG 3051: Amputation of lower limb except toes

Facility

$53,583.16

Service Code	APR-DRG 3051
Min. Negotiated Rate	$15,487.00
Max. Negotiated Rate	$53,583.16
Rate for Payer: Affinity Essential Plan 1&2	$53,583.16
Rate for Payer: Affinity Essential Plan 3&4	$53,583.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,814.74
Rate for Payer: Amida Care Medicaid	$23,814.74
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,814.74
Rate for Payer: Fidelis Qualified Health Plan	$28,577.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,814.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,814.74
Rate for Payer: Healthfirst Commercial	$29,901.00
Rate for Payer: Healthfirst Essential Plan	$53,583.16
Rate for Payer: Healthfirst QHP	$15,487.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,814.74
Rate for Payer: SOMOS Essential	$53,583.16
Rate for Payer: United Healthcare Essential Plan 1&2	$53,583.16
Rate for Payer: United Healthcare Essential Plan 3&4	$53,583.16
Rate for Payer: United Healthcare Medicaid	$23,814.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,814.74

APR-DRG 3052: Amputation of lower limb except toes

Facility

$63,360.04

Service Code	APR-DRG 3052
Min. Negotiated Rate	$21,769.00
Max. Negotiated Rate	$63,360.04
Rate for Payer: Affinity Essential Plan 1&2	$63,360.04
Rate for Payer: Affinity Essential Plan 3&4	$63,360.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,160.02
Rate for Payer: Amida Care Medicaid	$28,160.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,160.02
Rate for Payer: Fidelis Qualified Health Plan	$33,792.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,160.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,160.02
Rate for Payer: Healthfirst Commercial	$38,655.00
Rate for Payer: Healthfirst Essential Plan	$63,360.04
Rate for Payer: Healthfirst QHP	$21,769.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,160.02
Rate for Payer: SOMOS Essential	$63,360.04
Rate for Payer: United Healthcare Essential Plan 1&2	$63,360.04
Rate for Payer: United Healthcare Essential Plan 3&4	$63,360.04
Rate for Payer: United Healthcare Medicaid	$28,160.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,160.02

APR-DRG 3053: Amputation of lower limb except toes

Facility

$89,122.16

Service Code	APR-DRG 3053
Min. Negotiated Rate	$33,121.00
Max. Negotiated Rate	$89,122.16
Rate for Payer: Affinity Essential Plan 1&2	$89,122.16
Rate for Payer: Affinity Essential Plan 3&4	$89,122.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$39,609.85
Rate for Payer: Amida Care Medicaid	$39,609.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,609.85
Rate for Payer: Fidelis Qualified Health Plan	$47,531.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,609.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,609.85
Rate for Payer: Healthfirst Commercial	$57,153.00
Rate for Payer: Healthfirst Essential Plan	$89,122.16
Rate for Payer: Healthfirst QHP	$33,121.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,609.85
Rate for Payer: SOMOS Essential	$89,122.16
Rate for Payer: United Healthcare Essential Plan 1&2	$89,122.16
Rate for Payer: United Healthcare Essential Plan 3&4	$89,122.16
Rate for Payer: United Healthcare Medicaid	$39,609.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,609.85

APR-DRG 3054: Amputation of lower limb except toes

Facility

$140,475.78

Service Code	APR-DRG 3054
Min. Negotiated Rate	$61,247.00
Max. Negotiated Rate	$140,475.78
Rate for Payer: Affinity Essential Plan 1&2	$140,475.78
Rate for Payer: Affinity Essential Plan 3&4	$140,475.78
Rate for Payer: Affinity Medicaid/CHP/HARP	$62,433.68
Rate for Payer: Amida Care Medicaid	$62,433.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$62,433.68
Rate for Payer: Fidelis Qualified Health Plan	$74,920.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$62,433.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62,433.68
Rate for Payer: Healthfirst Commercial	$125,142.00
Rate for Payer: Healthfirst Essential Plan	$140,475.78
Rate for Payer: Healthfirst QHP	$61,247.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62,433.68
Rate for Payer: SOMOS Essential	$140,475.78
Rate for Payer: United Healthcare Essential Plan 1&2	$140,475.78
Rate for Payer: United Healthcare Essential Plan 3&4	$140,475.78
Rate for Payer: United Healthcare Medicaid	$62,433.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$62,433.68

APR-DRG 3081: Hip and femur fracture repair

Facility

$53,132.94

Service Code	APR-DRG 3081
Min. Negotiated Rate	$14,878.00
Max. Negotiated Rate	$53,132.94
Rate for Payer: Affinity Essential Plan 1&2	$53,132.94
Rate for Payer: Affinity Essential Plan 3&4	$53,132.94
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,614.64
Rate for Payer: Amida Care Medicaid	$23,614.64
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,614.64
Rate for Payer: Fidelis Qualified Health Plan	$28,337.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,614.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,614.64
Rate for Payer: Healthfirst Commercial	$26,042.00
Rate for Payer: Healthfirst Essential Plan	$53,132.94
Rate for Payer: Healthfirst QHP	$14,878.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,614.64
Rate for Payer: SOMOS Essential	$53,132.94
Rate for Payer: United Healthcare Essential Plan 1&2	$53,132.94
Rate for Payer: United Healthcare Essential Plan 3&4	$53,132.94
Rate for Payer: United Healthcare Medicaid	$23,614.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,614.64

APR-DRG 3082: Hip and femur fracture repair

Facility

$61,982.96

Service Code	APR-DRG 3082
Min. Negotiated Rate	$19,036.00
Max. Negotiated Rate	$61,982.96
Rate for Payer: Affinity Essential Plan 1&2	$61,982.96
Rate for Payer: Affinity Essential Plan 3&4	$61,982.96
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,547.98
Rate for Payer: Amida Care Medicaid	$27,547.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,547.98
Rate for Payer: Fidelis Qualified Health Plan	$33,057.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,547.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,547.98
Rate for Payer: Healthfirst Commercial	$32,196.00
Rate for Payer: Healthfirst Essential Plan	$61,982.96
Rate for Payer: Healthfirst QHP	$19,036.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,547.98
Rate for Payer: SOMOS Essential	$61,982.96
Rate for Payer: United Healthcare Essential Plan 1&2	$61,982.96
Rate for Payer: United Healthcare Essential Plan 3&4	$61,982.96
Rate for Payer: United Healthcare Medicaid	$27,547.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,547.98

APR-DRG 3083: Hip and femur fracture repair

Facility

$77,933.02

Service Code	APR-DRG 3083
Min. Negotiated Rate	$28,506.00
Max. Negotiated Rate	$77,933.02
Rate for Payer: Affinity Essential Plan 1&2	$77,933.02
Rate for Payer: Affinity Essential Plan 3&4	$77,933.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,636.90
Rate for Payer: Amida Care Medicaid	$34,636.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,636.90
Rate for Payer: Fidelis Qualified Health Plan	$41,564.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,636.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,636.90
Rate for Payer: Healthfirst Commercial	$44,697.00
Rate for Payer: Healthfirst Essential Plan	$77,933.02
Rate for Payer: Healthfirst QHP	$28,506.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,636.90
Rate for Payer: SOMOS Essential	$77,933.02
Rate for Payer: United Healthcare Essential Plan 1&2	$77,933.02
Rate for Payer: United Healthcare Essential Plan 3&4	$77,933.02
Rate for Payer: United Healthcare Medicaid	$34,636.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,636.90

APR-DRG 3084: Hip and femur fracture repair

Facility

$131,101.67

Service Code	APR-DRG 3084
Min. Negotiated Rate	$53,759.00
Max. Negotiated Rate	$131,101.67
Rate for Payer: Affinity Essential Plan 1&2	$131,101.67
Rate for Payer: Affinity Essential Plan 3&4	$131,101.67
Rate for Payer: Affinity Medicaid/CHP/HARP	$58,267.41
Rate for Payer: Amida Care Medicaid	$58,267.41
Rate for Payer: Fidelis CHP/HARP/Medicaid	$58,267.41
Rate for Payer: Fidelis Qualified Health Plan	$69,920.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$58,267.41
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58,267.41
Rate for Payer: Healthfirst Commercial	$82,315.00
Rate for Payer: Healthfirst Essential Plan	$131,101.67
Rate for Payer: Healthfirst QHP	$53,759.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58,267.41
Rate for Payer: SOMOS Essential	$131,101.67
Rate for Payer: United Healthcare Essential Plan 1&2	$131,101.67
Rate for Payer: United Healthcare Essential Plan 3&4	$131,101.67
Rate for Payer: United Healthcare Medicaid	$58,267.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$58,267.41

Know your out-of-pocket cost for care.

All Charges