St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 8502: Procedure w diag of rehab, aftercare or oth contact w health service

Facility IP

$58,799.61

Service Code	APR-DRG 8502
Min. Negotiated Rate	$17,219.00
Max. Negotiated Rate	$58,799.61
Rate for Payer: Amida Care Medicaid	$26,133.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,133.16
Rate for Payer: Fidelis Qualified Health Plan	$31,359.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,133.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,133.16
Rate for Payer: Healthfirst Commercial	$27,833.00
Rate for Payer: Healthfirst Essential Plan	$58,799.61
Rate for Payer: Healthfirst QHP	$17,219.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,133.16
Rate for Payer: SOMOS Essential	$58,799.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,133.16

APR-DRG 8503: Procedure w diag of rehab, aftercare or oth contact w health service

Facility IP

$86,579.01

Service Code	APR-DRG 8503
Min. Negotiated Rate	$38,479.56
Max. Negotiated Rate	$86,579.01
Rate for Payer: Amida Care Medicaid	$38,479.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$38,479.56
Rate for Payer: Fidelis Qualified Health Plan	$46,175.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$38,479.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38,479.56
Rate for Payer: Healthfirst Commercial	$66,679.00
Rate for Payer: Healthfirst Essential Plan	$86,579.01
Rate for Payer: Healthfirst QHP	$48,086.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,479.56
Rate for Payer: SOMOS Essential	$86,579.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$38,479.56

APR-DRG 8504: Procedure w diag of rehab, aftercare or oth contact w health service

Facility IP

$163,777.41

Service Code	APR-DRG 8504
Min. Negotiated Rate	$72,789.96
Max. Negotiated Rate	$163,777.41
Rate for Payer: Amida Care Medicaid	$72,789.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$72,789.96
Rate for Payer: Fidelis Qualified Health Plan	$87,347.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$72,789.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$72,789.96
Rate for Payer: Healthfirst Commercial	$116,985.00
Rate for Payer: Healthfirst Essential Plan	$163,777.41
Rate for Payer: Healthfirst QHP	$113,284.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$72,789.96
Rate for Payer: SOMOS Essential	$163,777.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$72,789.96

APR-DRG 8601: Rehabilitation

Facility IP

$56,592.38

Service Code	APR-DRG 8601
Min. Negotiated Rate	$14,770.00
Max. Negotiated Rate	$56,592.38
Rate for Payer: Amida Care Medicaid	$25,152.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,152.17
Rate for Payer: Fidelis Qualified Health Plan	$30,182.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,152.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,152.17
Rate for Payer: Healthfirst Commercial	$21,195.00
Rate for Payer: Healthfirst Essential Plan	$56,592.38
Rate for Payer: Healthfirst QHP	$14,770.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,152.17
Rate for Payer: SOMOS Essential	$56,592.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,152.17

APR-DRG 8602: Rehabilitation

Facility IP

$61,193.27

Service Code	APR-DRG 8602
Min. Negotiated Rate	$14,770.00
Max. Negotiated Rate	$61,193.27
Rate for Payer: Amida Care Medicaid	$27,197.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,197.01
Rate for Payer: Fidelis Qualified Health Plan	$32,636.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,197.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,197.01
Rate for Payer: Healthfirst Commercial	$21,778.00
Rate for Payer: Healthfirst Essential Plan	$61,193.27
Rate for Payer: Healthfirst QHP	$14,770.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,197.01
Rate for Payer: SOMOS Essential	$61,193.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,197.01

APR-DRG 8603: Rehabilitation

Facility IP

$71,364.10

Service Code	APR-DRG 8603
Min. Negotiated Rate	$16,704.00
Max. Negotiated Rate	$71,364.10
Rate for Payer: Amida Care Medicaid	$31,717.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,717.38
Rate for Payer: Fidelis Qualified Health Plan	$38,060.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,717.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,717.38
Rate for Payer: Healthfirst Commercial	$36,304.00
Rate for Payer: Healthfirst Essential Plan	$71,364.10
Rate for Payer: Healthfirst QHP	$16,704.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,717.38
Rate for Payer: SOMOS Essential	$71,364.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,717.38

APR-DRG 8604: Rehabilitation

Facility IP

$71,364.10

Service Code	APR-DRG 8604
Min. Negotiated Rate	$17,221.00
Max. Negotiated Rate	$71,364.10
Rate for Payer: Amida Care Medicaid	$31,717.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,717.38
Rate for Payer: Fidelis Qualified Health Plan	$38,060.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,717.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,717.38
Rate for Payer: Healthfirst Commercial	$39,229.00
Rate for Payer: Healthfirst Essential Plan	$71,364.10
Rate for Payer: Healthfirst QHP	$17,221.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,717.38
Rate for Payer: SOMOS Essential	$71,364.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,717.38

APR-DRG 8611: Signs, symptoms & other factors influencing health status

Facility IP

$37,561.00

Service Code	APR-DRG 8611
Min. Negotiated Rate	$5,052.00
Max. Negotiated Rate	$37,561.00
Rate for Payer: Amida Care Medicaid	$16,693.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,693.78
Rate for Payer: Fidelis Qualified Health Plan	$20,032.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,693.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,693.78
Rate for Payer: Healthfirst Commercial	$8,915.00
Rate for Payer: Healthfirst Essential Plan	$37,561.00
Rate for Payer: Healthfirst QHP	$5,052.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,693.78
Rate for Payer: SOMOS Essential	$37,561.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,693.78

APR-DRG 8612: Signs, symptoms & other factors influencing health status

Facility IP

$40,728.49

Service Code	APR-DRG 8612
Min. Negotiated Rate	$6,850.00
Max. Negotiated Rate	$40,728.49
Rate for Payer: Amida Care Medicaid	$18,101.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,101.55
Rate for Payer: Fidelis Qualified Health Plan	$21,721.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,101.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,101.55
Rate for Payer: Healthfirst Commercial	$11,582.00
Rate for Payer: Healthfirst Essential Plan	$40,728.49
Rate for Payer: Healthfirst QHP	$6,850.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,101.55
Rate for Payer: SOMOS Essential	$40,728.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,101.55

APR-DRG 8613: Signs, symptoms & other factors influencing health status

Facility IP

$48,247.13

Service Code	APR-DRG 8613
Min. Negotiated Rate	$10,407.00
Max. Negotiated Rate	$48,247.13
Rate for Payer: Amida Care Medicaid	$21,443.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,443.17
Rate for Payer: Fidelis Qualified Health Plan	$25,731.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,443.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,443.17
Rate for Payer: Healthfirst Commercial	$17,405.00
Rate for Payer: Healthfirst Essential Plan	$48,247.13
Rate for Payer: Healthfirst QHP	$10,407.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,443.17
Rate for Payer: SOMOS Essential	$48,247.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,443.17

APR-DRG 8614: Signs, symptoms & other factors influencing health status

Facility IP

$66,404.43

Service Code	APR-DRG 8614
Min. Negotiated Rate	$20,017.00
Max. Negotiated Rate	$66,404.43
Rate for Payer: Amida Care Medicaid	$29,513.08
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,513.08
Rate for Payer: Fidelis Qualified Health Plan	$35,415.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,513.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,513.08
Rate for Payer: Healthfirst Commercial	$39,190.00
Rate for Payer: Healthfirst Essential Plan	$66,404.43
Rate for Payer: Healthfirst QHP	$20,017.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,513.08
Rate for Payer: SOMOS Essential	$66,404.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,513.08

APR-DRG 8621: Other aftercare & convalescence

Facility IP

$38,649.67

Service Code	APR-DRG 8621
Min. Negotiated Rate	$6,547.00
Max. Negotiated Rate	$38,649.67
Rate for Payer: Amida Care Medicaid	$17,177.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,177.63
Rate for Payer: Fidelis Qualified Health Plan	$20,613.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,177.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,177.63
Rate for Payer: Healthfirst Commercial	$10,707.00
Rate for Payer: Healthfirst Essential Plan	$38,649.67
Rate for Payer: Healthfirst QHP	$6,547.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,177.63
Rate for Payer: SOMOS Essential	$38,649.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,177.63

APR-DRG 8622: Other aftercare & convalescence

Facility IP

$42,545.27

Service Code	APR-DRG 8622
Min. Negotiated Rate	$9,780.00
Max. Negotiated Rate	$42,545.27
Rate for Payer: Amida Care Medicaid	$18,909.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,909.01
Rate for Payer: Fidelis Qualified Health Plan	$22,690.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,909.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,909.01
Rate for Payer: Healthfirst Commercial	$14,282.00
Rate for Payer: Healthfirst Essential Plan	$42,545.27
Rate for Payer: Healthfirst QHP	$9,780.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,909.01
Rate for Payer: SOMOS Essential	$42,545.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,909.01

APR-DRG 8623: Other aftercare & convalescence

Facility IP

$51,245.80

Service Code	APR-DRG 8623
Min. Negotiated Rate	$15,628.00
Max. Negotiated Rate	$51,245.80
Rate for Payer: Amida Care Medicaid	$22,775.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,775.91
Rate for Payer: Fidelis Qualified Health Plan	$27,331.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,775.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,775.91
Rate for Payer: Healthfirst Commercial	$18,445.00
Rate for Payer: Healthfirst Essential Plan	$51,245.80
Rate for Payer: Healthfirst QHP	$15,628.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,775.91
Rate for Payer: SOMOS Essential	$51,245.80
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,775.91

APR-DRG 8624: Other aftercare & convalescence

Facility IP

$67,324.25

Service Code	APR-DRG 8624
Min. Negotiated Rate	$23,041.00
Max. Negotiated Rate	$67,324.25
Rate for Payer: Amida Care Medicaid	$29,921.89
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,921.89
Rate for Payer: Fidelis Qualified Health Plan	$35,906.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,921.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,921.89
Rate for Payer: Healthfirst Commercial	$23,041.00
Rate for Payer: Healthfirst Essential Plan	$67,324.25
Rate for Payer: Healthfirst QHP	$24,956.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,921.89
Rate for Payer: SOMOS Essential	$67,324.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,921.89

APR-DRG 8631: Neonatal aftercare

Facility IP

$45,656.50

Service Code	APR-DRG 8631
Min. Negotiated Rate	$10,554.00
Max. Negotiated Rate	$45,656.50
Rate for Payer: Amida Care Medicaid	$20,291.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,291.78
Rate for Payer: Fidelis Qualified Health Plan	$24,350.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,291.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,291.78
Rate for Payer: Healthfirst Commercial	$15,119.00
Rate for Payer: Healthfirst Essential Plan	$45,656.50
Rate for Payer: Healthfirst QHP	$10,554.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,291.78
Rate for Payer: SOMOS Essential	$45,656.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,291.78

APR-DRG 8632: Neonatal aftercare

Facility IP

$68,145.59

Service Code	APR-DRG 8632
Min. Negotiated Rate	$20,424.00
Max. Negotiated Rate	$68,145.59
Rate for Payer: Amida Care Medicaid	$30,286.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,286.93
Rate for Payer: Fidelis Qualified Health Plan	$36,344.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,286.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,286.93
Rate for Payer: Healthfirst Commercial	$29,534.00
Rate for Payer: Healthfirst Essential Plan	$68,145.59
Rate for Payer: Healthfirst QHP	$20,424.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,286.93
Rate for Payer: SOMOS Essential	$68,145.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,286.93

APR-DRG 8633: Neonatal aftercare

Facility IP

$102,657.46

Service Code	APR-DRG 8633
Min. Negotiated Rate	$34,701.00
Max. Negotiated Rate	$102,657.46
Rate for Payer: Amida Care Medicaid	$45,625.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,625.54
Rate for Payer: Fidelis Qualified Health Plan	$54,750.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,625.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,625.54
Rate for Payer: Healthfirst Commercial	$69,682.00
Rate for Payer: Healthfirst Essential Plan	$102,657.46
Rate for Payer: Healthfirst QHP	$34,701.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,625.54
Rate for Payer: SOMOS Essential	$102,657.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,625.54

APR-DRG 8634: Neonatal aftercare

Facility IP

$122,839.09

Service Code	APR-DRG 8634
Min. Negotiated Rate	$48,995.00
Max. Negotiated Rate	$122,839.09
Rate for Payer: Amida Care Medicaid	$54,595.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54,595.15
Rate for Payer: Fidelis Qualified Health Plan	$65,514.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$54,595.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54,595.15
Rate for Payer: Healthfirst Commercial	$92,215.00
Rate for Payer: Healthfirst Essential Plan	$122,839.09
Rate for Payer: Healthfirst QHP	$48,995.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54,595.15
Rate for Payer: SOMOS Essential	$122,839.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$54,595.15

APR-DRG 8901: HIV w multiple major HIV related conditions

Facility IP

$49,226.76

Service Code	APR-DRG 8901
Min. Negotiated Rate	$14,298.00
Max. Negotiated Rate	$49,226.76
Rate for Payer: Amida Care Medicaid	$21,878.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,878.56
Rate for Payer: Fidelis Qualified Health Plan	$26,254.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,878.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,878.56
Rate for Payer: Healthfirst Commercial	$20,987.00
Rate for Payer: Healthfirst Essential Plan	$49,226.76
Rate for Payer: Healthfirst QHP	$14,298.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,878.56
Rate for Payer: SOMOS Essential	$49,226.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,878.56

APR-DRG 8902: HIV w multiple major HIV related conditions

Facility IP

$49,254.91

Service Code	APR-DRG 8902
Min. Negotiated Rate	$14,298.00
Max. Negotiated Rate	$49,254.91
Rate for Payer: Amida Care Medicaid	$21,891.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,891.07
Rate for Payer: Fidelis Qualified Health Plan	$26,269.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,891.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,891.07
Rate for Payer: Healthfirst Commercial	$21,044.00
Rate for Payer: Healthfirst Essential Plan	$49,254.91
Rate for Payer: Healthfirst QHP	$14,298.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,891.07
Rate for Payer: SOMOS Essential	$49,254.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,891.07

APR-DRG 8903: HIV w multiple major HIV related conditions

Facility IP

$63,516.58

Service Code	APR-DRG 8903
Min. Negotiated Rate	$20,766.00
Max. Negotiated Rate	$63,516.58
Rate for Payer: Amida Care Medicaid	$28,229.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,229.59
Rate for Payer: Fidelis Qualified Health Plan	$33,875.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,229.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,229.59
Rate for Payer: Healthfirst Commercial	$31,328.00
Rate for Payer: Healthfirst Essential Plan	$63,516.58
Rate for Payer: Healthfirst QHP	$20,766.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,229.59
Rate for Payer: SOMOS Essential	$63,516.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,229.59

APR-DRG 8904: HIV w multiple major HIV related conditions

Facility IP

$96,238.06

Service Code	APR-DRG 8904
Min. Negotiated Rate	$40,051.00
Max. Negotiated Rate	$96,238.06
Rate for Payer: Amida Care Medicaid	$42,772.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$42,772.47
Rate for Payer: Fidelis Qualified Health Plan	$51,326.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$42,772.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42,772.47
Rate for Payer: Healthfirst Commercial	$63,688.00
Rate for Payer: Healthfirst Essential Plan	$96,238.06
Rate for Payer: Healthfirst QHP	$40,051.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42,772.47
Rate for Payer: SOMOS Essential	$96,238.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$42,772.47

APR-DRG 8921: HIV w major HIV related condition

Facility IP

$42,307.85

Service Code	APR-DRG 8921
Min. Negotiated Rate	$10,237.00
Max. Negotiated Rate	$42,307.85
Rate for Payer: Amida Care Medicaid	$18,803.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,803.49
Rate for Payer: Fidelis Qualified Health Plan	$22,564.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,803.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,803.49
Rate for Payer: Healthfirst Commercial	$15,754.00
Rate for Payer: Healthfirst Essential Plan	$42,307.85
Rate for Payer: Healthfirst QHP	$10,237.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,803.49
Rate for Payer: SOMOS Essential	$42,307.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,803.49

APR-DRG 8922: HIV w major HIV related condition

Facility IP

$46,053.99

Service Code	APR-DRG 8922
Min. Negotiated Rate	$10,943.00
Max. Negotiated Rate	$46,053.99
Rate for Payer: Amida Care Medicaid	$20,468.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,468.44
Rate for Payer: Fidelis Qualified Health Plan	$24,562.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,468.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,468.44
Rate for Payer: Healthfirst Commercial	$15,754.00
Rate for Payer: Healthfirst Essential Plan	$46,053.99
Rate for Payer: Healthfirst QHP	$10,943.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,468.44
Rate for Payer: SOMOS Essential	$46,053.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,468.44

Price Transparency.

All Charges