St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OUTPATIENT EAPG 00147: LEVEL III LAPAROSCOPY

Facility

$4,575.90

Service Code	EAPG 00147
Hospital Charge Code	EAPG 00147
Min. Negotiated Rate	$4,575.90
Max. Negotiated Rate	$4,575.90
Rate for Payer: Healthfirst Commercial	$4,575.90

OUTPATIENT EAPG 00148: LEVEL IV LAPAROSCOPY

Facility

$8,333.28

Service Code	EAPG 00148
Hospital Charge Code	EAPG 00148
Min. Negotiated Rate	$3,703.68
Max. Negotiated Rate	$8,333.28
Rate for Payer: Affinity Essential Plan 1&2	$8,333.28
Rate for Payer: Affinity Essential Plan 3&4	$8,333.28
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,703.68
Rate for Payer: Amida Care Medicaid	$3,703.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,703.68
Rate for Payer: Fidelis Essential Plan Aliesa	$8,333.28
Rate for Payer: Fidelis Essential Plan QHP	$8,333.28
Rate for Payer: Fidelis Qualified Health Plan	$3,888.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,703.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,703.68
Rate for Payer: Healthfirst Commercial	$5,612.32
Rate for Payer: Healthfirst Essential Plan	$8,333.28
Rate for Payer: Healthfirst QHP	$3,703.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,703.68
Rate for Payer: SOMOS Essential	$8,333.28
Rate for Payer: United Healthcare Essential Plan 1&2	$8,333.28
Rate for Payer: United Healthcare Essential Plan 3&4	$4,074.05
Rate for Payer: United Healthcare Medicaid	$3,703.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,703.68

OUTPATIENT EAPG 00149: SCREENING COLORECTAL SERVICES

Facility

$1,998.81

Service Code	EAPG 00149
Hospital Charge Code	EAPG 00149
Min. Negotiated Rate	$888.36
Max. Negotiated Rate	$1,998.81
Rate for Payer: Affinity Essential Plan 1&2	$1,998.81
Rate for Payer: Affinity Essential Plan 3&4	$1,998.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$888.36
Rate for Payer: Amida Care Medicaid	$888.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$888.36
Rate for Payer: Fidelis Essential Plan Aliesa	$1,998.81
Rate for Payer: Fidelis Essential Plan QHP	$1,998.81
Rate for Payer: Fidelis Qualified Health Plan	$932.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$888.36
Rate for Payer: Healthfirst Commercial	$1,346.17
Rate for Payer: Healthfirst Essential Plan	$1,998.81
Rate for Payer: Healthfirst QHP	$888.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$888.36
Rate for Payer: SOMOS Essential	$1,998.81
Rate for Payer: United Healthcare Essential Plan 1&2	$1,998.81
Rate for Payer: United Healthcare Essential Plan 3&4	$977.20
Rate for Payer: United Healthcare Medicaid	$888.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$888.36

OUTPATIENT EAPG 00150: ABDOMINAL PARACENTESIS AND RELATED PERITONEAL DRAINAGE PROCEDURES

Facility

$1,557.36

Service Code	EAPG 00150
Hospital Charge Code	EAPG 00150
Min. Negotiated Rate	$692.16
Max. Negotiated Rate	$1,557.36
Rate for Payer: Affinity Essential Plan 1&2	$1,557.36
Rate for Payer: Affinity Essential Plan 3&4	$1,557.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$692.16
Rate for Payer: Amida Care Medicaid	$692.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$692.16
Rate for Payer: Fidelis Essential Plan Aliesa	$1,557.36
Rate for Payer: Fidelis Essential Plan QHP	$1,557.36
Rate for Payer: Fidelis Qualified Health Plan	$726.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$692.16
Rate for Payer: Healthfirst Essential Plan	$1,557.36
Rate for Payer: Healthfirst QHP	$692.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$692.16
Rate for Payer: SOMOS Essential	$1,557.36
Rate for Payer: United Healthcare Essential Plan 1&2	$1,557.36
Rate for Payer: United Healthcare Essential Plan 3&4	$761.38
Rate for Payer: United Healthcare Medicaid	$692.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$692.16

OUTPATIENT EAPG 00151: LEVEL I HEPATOBILIARY AND PANCREAS PROCEDURES

Facility

$3,737.66

Service Code	EAPG 00151
Hospital Charge Code	EAPG 00151
Min. Negotiated Rate	$1,661.18
Max. Negotiated Rate	$3,737.66
Rate for Payer: Affinity Essential Plan 1&2	$3,737.66
Rate for Payer: Affinity Essential Plan 3&4	$3,737.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,661.18
Rate for Payer: Amida Care Medicaid	$1,661.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,661.18
Rate for Payer: Fidelis Essential Plan Aliesa	$3,737.66
Rate for Payer: Fidelis Essential Plan QHP	$3,737.66
Rate for Payer: Fidelis Qualified Health Plan	$1,744.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,661.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,661.18
Rate for Payer: Healthfirst Essential Plan	$3,737.66
Rate for Payer: Healthfirst QHP	$1,661.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,661.18
Rate for Payer: SOMOS Essential	$3,737.66
Rate for Payer: United Healthcare Essential Plan 1&2	$3,737.66
Rate for Payer: United Healthcare Essential Plan 3&4	$1,827.30
Rate for Payer: United Healthcare Medicaid	$1,661.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,661.18

OUTPATIENT EAPG 00152: LEVEL II HEPATOBILIARY AND PANCREAS PROCEDURES

Facility

$5,930.75

Service Code	EAPG 00152
Hospital Charge Code	EAPG 00152
Min. Negotiated Rate	$2,635.89
Max. Negotiated Rate	$5,930.75
Rate for Payer: Affinity Essential Plan 1&2	$5,930.75
Rate for Payer: Affinity Essential Plan 3&4	$5,930.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,635.89
Rate for Payer: Amida Care Medicaid	$2,635.89
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2,635.89
Rate for Payer: Fidelis Essential Plan Aliesa	$5,930.75
Rate for Payer: Fidelis Essential Plan QHP	$5,930.75
Rate for Payer: Fidelis Qualified Health Plan	$2,767.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,635.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,635.89
Rate for Payer: Healthfirst Essential Plan	$5,930.75
Rate for Payer: Healthfirst QHP	$2,635.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,635.89
Rate for Payer: SOMOS Essential	$5,930.75
Rate for Payer: United Healthcare Essential Plan 1&2	$5,930.75
Rate for Payer: United Healthcare Essential Plan 3&4	$2,899.48
Rate for Payer: United Healthcare Medicaid	$2,635.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,635.89

OUTPATIENT EAPG 00153: LEVEL II ERCP AND RELATED ENDOSCOPIC PROCEDURES

Facility

$3,698.46

Service Code	EAPG 00153
Hospital Charge Code	EAPG 00153
Min. Negotiated Rate	$1,643.76
Max. Negotiated Rate	$3,698.46
Rate for Payer: Affinity Essential Plan 1&2	$3,698.46
Rate for Payer: Affinity Essential Plan 3&4	$3,698.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,643.76
Rate for Payer: Amida Care Medicaid	$1,643.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,643.76
Rate for Payer: Fidelis Essential Plan Aliesa	$3,698.46
Rate for Payer: Fidelis Essential Plan QHP	$3,698.46
Rate for Payer: Fidelis Qualified Health Plan	$1,725.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,643.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,643.76
Rate for Payer: Healthfirst Essential Plan	$3,698.46
Rate for Payer: Healthfirst QHP	$1,643.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,643.76
Rate for Payer: SOMOS Essential	$3,698.46
Rate for Payer: United Healthcare Essential Plan 1&2	$3,698.46
Rate for Payer: United Healthcare Essential Plan 3&4	$1,808.14
Rate for Payer: United Healthcare Medicaid	$1,643.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,643.76

OUTPATIENT EAPG 00154: LEVEL III UPPER GI ENDOSCOPY

Facility

$2,523.87

Service Code	EAPG 00154
Hospital Charge Code	EAPG 00154
Min. Negotiated Rate	$1,121.72
Max. Negotiated Rate	$2,523.87
Rate for Payer: Affinity Essential Plan 1&2	$2,523.87
Rate for Payer: Affinity Essential Plan 3&4	$2,523.87
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,121.72
Rate for Payer: Amida Care Medicaid	$1,121.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,121.72
Rate for Payer: Fidelis Essential Plan Aliesa	$2,523.87
Rate for Payer: Fidelis Essential Plan QHP	$2,523.87
Rate for Payer: Fidelis Qualified Health Plan	$1,177.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,121.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,121.72
Rate for Payer: Healthfirst Essential Plan	$2,523.87
Rate for Payer: Healthfirst QHP	$1,121.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,121.72
Rate for Payer: SOMOS Essential	$2,523.87
Rate for Payer: United Healthcare Essential Plan 1&2	$2,523.87
Rate for Payer: United Healthcare Essential Plan 3&4	$1,233.89
Rate for Payer: United Healthcare Medicaid	$1,121.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,121.72

OUTPATIENT EAPG 00160: EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY

Facility

$4,476.71

Service Code	EAPG 00160
Hospital Charge Code	EAPG 00160
Min. Negotiated Rate	$4,476.71
Max. Negotiated Rate	$4,476.71
Rate for Payer: Healthfirst Commercial	$4,476.71

OUTPATIENT EAPG 00161: URINARY STUDIES AND PROCEDURES

Facility

$1,098.20

Service Code	EAPG 00161
Hospital Charge Code	EAPG 00161
Min. Negotiated Rate	$488.09
Max. Negotiated Rate	$1,098.20
Rate for Payer: Affinity Essential Plan 1&2	$1,098.20
Rate for Payer: Affinity Essential Plan 3&4	$1,098.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$488.09
Rate for Payer: Amida Care Medicaid	$488.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$488.09
Rate for Payer: Fidelis Essential Plan Aliesa	$1,098.20
Rate for Payer: Fidelis Essential Plan QHP	$1,098.20
Rate for Payer: Fidelis Qualified Health Plan	$512.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$488.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$488.09
Rate for Payer: Healthfirst Commercial	$739.63
Rate for Payer: Healthfirst Essential Plan	$1,098.20
Rate for Payer: Healthfirst QHP	$488.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$488.09
Rate for Payer: SOMOS Essential	$1,098.20
Rate for Payer: United Healthcare Essential Plan 1&2	$1,098.20
Rate for Payer: United Healthcare Essential Plan 3&4	$536.90
Rate for Payer: United Healthcare Medicaid	$488.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$488.09

OUTPATIENT EAPG 00162: URINARY DILATATION

Facility

$553.96

Service Code	EAPG 00162
Hospital Charge Code	EAPG 00162
Min. Negotiated Rate	$553.96
Max. Negotiated Rate	$553.96
Rate for Payer: Healthfirst Commercial	$553.96

OUTPATIENT EAPG 00163: LEVEL I BLADDER AND KIDNEY PROCEDURES

Facility

$1,567.49

Service Code	EAPG 00163
Hospital Charge Code	EAPG 00163
Min. Negotiated Rate	$1,567.49
Max. Negotiated Rate	$1,567.49
Rate for Payer: Healthfirst Commercial	$1,567.49

OUTPATIENT EAPG 00164: LEVEL II BLADDER AND KIDNEY PROCEDURES

Facility

$3,439.71

Service Code	EAPG 00164
Hospital Charge Code	EAPG 00164
Min. Negotiated Rate	$3,439.71
Max. Negotiated Rate	$3,439.71
Rate for Payer: Healthfirst Commercial	$3,439.71

OUTPATIENT EAPG 00165: LEVEL III BLADDER AND KIDNEY PROCEDURES

Facility

$3,613.51

Service Code	EAPG 00165
Hospital Charge Code	EAPG 00165
Min. Negotiated Rate	$3,613.51
Max. Negotiated Rate	$3,613.51
Rate for Payer: Healthfirst Commercial	$3,613.51

OUTPATIENT EAPG 00166: LEVEL I URETHRA AND PROSTATE PROCEDURES

Facility

$2,592.27

Service Code	EAPG 00166
Hospital Charge Code	EAPG 00166
Min. Negotiated Rate	$1,152.12
Max. Negotiated Rate	$2,592.27
Rate for Payer: Affinity Essential Plan 1&2	$2,592.27
Rate for Payer: Affinity Essential Plan 3&4	$2,592.27
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,152.12
Rate for Payer: Amida Care Medicaid	$1,152.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,152.12
Rate for Payer: Fidelis Essential Plan Aliesa	$2,592.27
Rate for Payer: Fidelis Essential Plan QHP	$2,592.27
Rate for Payer: Fidelis Qualified Health Plan	$1,209.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,152.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,152.12
Rate for Payer: Healthfirst Commercial	$1,745.84
Rate for Payer: Healthfirst Essential Plan	$2,592.27
Rate for Payer: Healthfirst QHP	$1,152.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,152.12
Rate for Payer: SOMOS Essential	$2,592.27
Rate for Payer: United Healthcare Essential Plan 1&2	$2,592.27
Rate for Payer: United Healthcare Essential Plan 3&4	$1,267.33
Rate for Payer: United Healthcare Medicaid	$1,152.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,152.12

OUTPATIENT EAPG 00167: LEVEL II URETHRA AND PROSTATE PROCEDURES

Facility

$6,539.24

Service Code	EAPG 00167
Hospital Charge Code	EAPG 00167
Min. Negotiated Rate	$2,906.33
Max. Negotiated Rate	$6,539.24
Rate for Payer: Affinity Essential Plan 1&2	$6,539.24
Rate for Payer: Affinity Essential Plan 3&4	$6,539.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,906.33
Rate for Payer: Amida Care Medicaid	$2,906.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2,906.33
Rate for Payer: Fidelis Essential Plan Aliesa	$6,539.24
Rate for Payer: Fidelis Essential Plan QHP	$6,539.24
Rate for Payer: Fidelis Qualified Health Plan	$3,051.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,906.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,906.33
Rate for Payer: Healthfirst Commercial	$4,404.06
Rate for Payer: Healthfirst Essential Plan	$6,539.24
Rate for Payer: Healthfirst QHP	$2,906.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,906.33
Rate for Payer: SOMOS Essential	$6,539.24
Rate for Payer: United Healthcare Essential Plan 1&2	$6,539.24
Rate for Payer: United Healthcare Essential Plan 3&4	$3,196.96
Rate for Payer: United Healthcare Medicaid	$2,906.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,906.33

OUTPATIENT EAPG 00168: HEMODIALYSIS

Facility

$646.22

Service Code	EAPG 00168
Hospital Charge Code	EAPG 00168
Min. Negotiated Rate	$287.21
Max. Negotiated Rate	$646.22
Rate for Payer: Affinity Essential Plan 1&2	$646.22
Rate for Payer: Affinity Essential Plan 3&4	$646.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$287.21
Rate for Payer: Amida Care Medicaid	$287.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$287.21
Rate for Payer: Fidelis Essential Plan Aliesa	$646.22
Rate for Payer: Fidelis Essential Plan QHP	$646.22
Rate for Payer: Fidelis Qualified Health Plan	$301.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$287.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$287.21
Rate for Payer: Healthfirst Commercial	$435.23
Rate for Payer: Healthfirst Essential Plan	$646.22
Rate for Payer: Healthfirst QHP	$287.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$287.21
Rate for Payer: SOMOS Essential	$646.22
Rate for Payer: United Healthcare Essential Plan 1&2	$646.22
Rate for Payer: United Healthcare Essential Plan 3&4	$315.93
Rate for Payer: United Healthcare Medicaid	$287.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$287.21

OUTPATIENT EAPG 00169: PERITONEAL DIALYSIS

Facility

$186.52

Service Code	EAPG 00169
Hospital Charge Code	EAPG 00169
Min. Negotiated Rate	$186.52
Max. Negotiated Rate	$186.52
Rate for Payer: Healthfirst Commercial	$186.52

OUTPATIENT EAPG 00180: TESTICULAR AND EPIDIDYMAL PROCEDURES

Facility

$3,359.02

Service Code	EAPG 00180
Hospital Charge Code	EAPG 00180
Min. Negotiated Rate	$1,492.90
Max. Negotiated Rate	$3,359.02
Rate for Payer: Affinity Essential Plan 1&2	$3,359.02
Rate for Payer: Affinity Essential Plan 3&4	$3,359.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,492.90
Rate for Payer: Amida Care Medicaid	$1,492.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,492.90
Rate for Payer: Fidelis Essential Plan Aliesa	$3,359.02
Rate for Payer: Fidelis Essential Plan QHP	$3,359.02
Rate for Payer: Fidelis Qualified Health Plan	$1,567.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,492.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,492.90
Rate for Payer: Healthfirst Commercial	$2,262.24
Rate for Payer: Healthfirst Essential Plan	$3,359.02
Rate for Payer: Healthfirst QHP	$1,492.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,492.90
Rate for Payer: SOMOS Essential	$3,359.02
Rate for Payer: United Healthcare Essential Plan 1&2	$3,359.02
Rate for Payer: United Healthcare Essential Plan 3&4	$1,642.19
Rate for Payer: United Healthcare Medicaid	$1,492.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,492.90

OUTPATIENT EAPG 00181: CIRCUMCISION

Facility

$2,062.18

Service Code	EAPG 00181
Hospital Charge Code	EAPG 00181
Min. Negotiated Rate	$2,062.18
Max. Negotiated Rate	$2,062.18
Rate for Payer: Healthfirst Commercial	$2,062.18

OUTPATIENT EAPG 00182: INSERTION OF PENILE PROSTHESIS

Facility

$13,660.20

Service Code	EAPG 00182
Hospital Charge Code	EAPG 00182
Min. Negotiated Rate	$6,071.20
Max. Negotiated Rate	$13,660.20
Rate for Payer: Affinity Essential Plan 1&2	$13,660.20
Rate for Payer: Affinity Essential Plan 3&4	$13,660.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$6,071.20
Rate for Payer: Amida Care Medicaid	$6,071.20
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6,071.20
Rate for Payer: Fidelis Essential Plan Aliesa	$13,660.20
Rate for Payer: Fidelis Essential Plan QHP	$13,660.20
Rate for Payer: Fidelis Qualified Health Plan	$6,374.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,071.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6,071.20
Rate for Payer: Healthfirst Commercial	$9,199.92
Rate for Payer: Healthfirst Essential Plan	$13,660.20
Rate for Payer: Healthfirst QHP	$6,071.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,071.20
Rate for Payer: SOMOS Essential	$13,660.20
Rate for Payer: United Healthcare Essential Plan 1&2	$13,660.20
Rate for Payer: United Healthcare Essential Plan 3&4	$6,678.32
Rate for Payer: United Healthcare Medicaid	$6,071.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,071.20

OUTPATIENT EAPG 00183: OTHER PENILE PROCEDURES

Facility

$2,443.46

Service Code	EAPG 00183
Hospital Charge Code	EAPG 00183
Min. Negotiated Rate	$1,085.98
Max. Negotiated Rate	$2,443.46
Rate for Payer: Affinity Essential Plan 1&2	$2,443.46
Rate for Payer: Affinity Essential Plan 3&4	$2,443.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,085.98
Rate for Payer: Amida Care Medicaid	$1,085.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,085.98
Rate for Payer: Fidelis Essential Plan Aliesa	$2,443.46
Rate for Payer: Fidelis Essential Plan QHP	$2,443.46
Rate for Payer: Fidelis Qualified Health Plan	$1,140.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,085.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,085.98
Rate for Payer: Healthfirst Commercial	$1,645.62
Rate for Payer: Healthfirst Essential Plan	$2,443.46
Rate for Payer: Healthfirst QHP	$1,085.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,085.98
Rate for Payer: SOMOS Essential	$2,443.46
Rate for Payer: United Healthcare Essential Plan 1&2	$2,443.46
Rate for Payer: United Healthcare Essential Plan 3&4	$1,194.58
Rate for Payer: United Healthcare Medicaid	$1,085.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,085.98

OUTPATIENT EAPG 00184: DESTRUCTION OR RESECTION OF PROSTATE

Facility

$6,958.24

Service Code	EAPG 00184
Hospital Charge Code	EAPG 00184
Min. Negotiated Rate	$3,092.55
Max. Negotiated Rate	$6,958.24
Rate for Payer: Affinity Essential Plan 1&2	$6,958.24
Rate for Payer: Affinity Essential Plan 3&4	$6,958.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,092.55
Rate for Payer: Amida Care Medicaid	$3,092.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,092.55
Rate for Payer: Fidelis Essential Plan Aliesa	$6,958.24
Rate for Payer: Fidelis Essential Plan QHP	$6,958.24
Rate for Payer: Fidelis Qualified Health Plan	$3,247.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,092.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,092.55
Rate for Payer: Healthfirst Commercial	$4,686.25
Rate for Payer: Healthfirst Essential Plan	$6,958.24
Rate for Payer: Healthfirst QHP	$3,092.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,092.55
Rate for Payer: SOMOS Essential	$6,958.24
Rate for Payer: United Healthcare Essential Plan 1&2	$6,958.24
Rate for Payer: United Healthcare Essential Plan 3&4	$3,401.80
Rate for Payer: United Healthcare Medicaid	$3,092.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,092.55

OUTPATIENT EAPG 00185: PROSTATE NEEDLE AND PUNCH BIOPSY

Facility

$1,810.29

Service Code	EAPG 00185
Hospital Charge Code	EAPG 00185
Min. Negotiated Rate	$1,810.29
Max. Negotiated Rate	$1,810.29
Rate for Payer: Healthfirst Commercial	$1,810.29

OUTPATIENT EAPG 00191: LEVEL I FETAL PROCEDURES

Facility

$613.91

Service Code	EAPG 00191
Hospital Charge Code	EAPG 00191
Min. Negotiated Rate	$272.85
Max. Negotiated Rate	$613.91
Rate for Payer: Affinity Essential Plan 1&2	$613.91
Rate for Payer: Affinity Essential Plan 3&4	$613.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$272.85
Rate for Payer: Amida Care Medicaid	$272.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$272.85
Rate for Payer: Fidelis Essential Plan Aliesa	$613.91
Rate for Payer: Fidelis Essential Plan QHP	$613.91
Rate for Payer: Fidelis Qualified Health Plan	$286.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$272.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$272.85
Rate for Payer: Healthfirst Commercial	$413.47
Rate for Payer: Healthfirst Essential Plan	$613.91
Rate for Payer: Healthfirst QHP	$272.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$272.85
Rate for Payer: SOMOS Essential	$613.91
Rate for Payer: United Healthcare Essential Plan 1&2	$613.91
Rate for Payer: United Healthcare Essential Plan 3&4	$300.14
Rate for Payer: United Healthcare Medicaid	$272.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$272.85

Know your out-of-pocket cost for care.

All Charges