St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 6624: Sickle cell anemia crisis

Facility

$87,898.07

Service Code	APR-DRG 6624
Min. Negotiated Rate	$33,284.00
Max. Negotiated Rate	$87,898.07
Rate for Payer: Affinity Essential Plan 1&2	$87,898.07
Rate for Payer: Affinity Essential Plan 3&4	$87,898.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$39,065.81
Rate for Payer: Amida Care Medicaid	$39,065.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,065.81
Rate for Payer: Fidelis Qualified Health Plan	$46,878.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,065.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,065.81
Rate for Payer: Healthfirst Commercial	$55,164.00
Rate for Payer: Healthfirst Essential Plan	$87,898.07
Rate for Payer: Healthfirst QHP	$33,284.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,065.81
Rate for Payer: SOMOS Essential	$87,898.07
Rate for Payer: United Healthcare Essential Plan 1&2	$87,898.07
Rate for Payer: United Healthcare Essential Plan 3&4	$87,898.07
Rate for Payer: United Healthcare Medicaid	$39,065.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,065.81

APR-DRG 6631: Other anemia & disorders of blood & blood-forming organs

Facility

$38,670.77

Service Code	APR-DRG 6631
Min. Negotiated Rate	$6,039.00
Max. Negotiated Rate	$38,670.77
Rate for Payer: Affinity Essential Plan 1&2	$38,670.77
Rate for Payer: Affinity Essential Plan 3&4	$38,670.77
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,187.01
Rate for Payer: Amida Care Medicaid	$17,187.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,187.01
Rate for Payer: Fidelis Qualified Health Plan	$20,624.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,187.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,187.01
Rate for Payer: Healthfirst Commercial	$10,238.00
Rate for Payer: Healthfirst Essential Plan	$38,670.77
Rate for Payer: Healthfirst QHP	$6,039.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,187.01
Rate for Payer: SOMOS Essential	$38,670.77
Rate for Payer: United Healthcare Essential Plan 1&2	$38,670.77
Rate for Payer: United Healthcare Essential Plan 3&4	$38,670.77
Rate for Payer: United Healthcare Medicaid	$17,187.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,187.01

APR-DRG 6632: Other anemia & disorders of blood & blood-forming organs

Facility

$42,035.24

Service Code	APR-DRG 6632
Min. Negotiated Rate	$7,673.00
Max. Negotiated Rate	$42,035.24
Rate for Payer: Affinity Essential Plan 1&2	$42,035.24
Rate for Payer: Affinity Essential Plan 3&4	$42,035.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,682.33
Rate for Payer: Amida Care Medicaid	$18,682.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,682.33
Rate for Payer: Fidelis Qualified Health Plan	$22,418.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,682.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,682.33
Rate for Payer: Healthfirst Commercial	$13,211.00
Rate for Payer: Healthfirst Essential Plan	$42,035.24
Rate for Payer: Healthfirst QHP	$7,673.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,682.33
Rate for Payer: SOMOS Essential	$42,035.24
Rate for Payer: United Healthcare Essential Plan 1&2	$42,035.24
Rate for Payer: United Healthcare Essential Plan 3&4	$42,035.24
Rate for Payer: United Healthcare Medicaid	$18,682.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,682.33

APR-DRG 6633: Other anemia & disorders of blood & blood-forming organs

Facility

$49,172.24

Service Code	APR-DRG 6633
Min. Negotiated Rate	$11,012.00
Max. Negotiated Rate	$49,172.24
Rate for Payer: Affinity Essential Plan 1&2	$49,172.24
Rate for Payer: Affinity Essential Plan 3&4	$49,172.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,854.33
Rate for Payer: Amida Care Medicaid	$21,854.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,854.33
Rate for Payer: Fidelis Qualified Health Plan	$26,225.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,854.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,854.33
Rate for Payer: Healthfirst Commercial	$19,159.00
Rate for Payer: Healthfirst Essential Plan	$49,172.24
Rate for Payer: Healthfirst QHP	$11,012.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,854.33
Rate for Payer: SOMOS Essential	$49,172.24
Rate for Payer: United Healthcare Essential Plan 1&2	$49,172.24
Rate for Payer: United Healthcare Essential Plan 3&4	$49,172.24
Rate for Payer: United Healthcare Medicaid	$21,854.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,854.33

APR-DRG 6634: Other anemia & disorders of blood & blood-forming organs

Facility

$71,068.64

Service Code	APR-DRG 6634
Min. Negotiated Rate	$22,326.00
Max. Negotiated Rate	$71,068.64
Rate for Payer: Affinity Essential Plan 1&2	$71,068.64
Rate for Payer: Affinity Essential Plan 3&4	$71,068.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$31,586.06
Rate for Payer: Amida Care Medicaid	$31,586.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,586.06
Rate for Payer: Fidelis Qualified Health Plan	$37,903.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,586.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,586.06
Rate for Payer: Healthfirst Commercial	$35,258.00
Rate for Payer: Healthfirst Essential Plan	$71,068.64
Rate for Payer: Healthfirst QHP	$22,326.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,586.06
Rate for Payer: SOMOS Essential	$71,068.64
Rate for Payer: United Healthcare Essential Plan 1&2	$71,068.64
Rate for Payer: United Healthcare Essential Plan 3&4	$71,068.64
Rate for Payer: United Healthcare Medicaid	$31,586.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,586.06

APR-DRG 6801: Major O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$53,984.16

Service Code	APR-DRG 6801
Min. Negotiated Rate	$16,208.00
Max. Negotiated Rate	$53,984.16
Rate for Payer: Affinity Essential Plan 1&2	$53,984.16
Rate for Payer: Affinity Essential Plan 3&4	$53,984.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,992.96
Rate for Payer: Amida Care Medicaid	$23,992.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,992.96
Rate for Payer: Fidelis Qualified Health Plan	$28,791.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,992.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,992.96
Rate for Payer: Healthfirst Commercial	$26,132.00
Rate for Payer: Healthfirst Essential Plan	$53,984.16
Rate for Payer: Healthfirst QHP	$16,208.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,992.96
Rate for Payer: SOMOS Essential	$53,984.16
Rate for Payer: United Healthcare Essential Plan 1&2	$53,984.16
Rate for Payer: United Healthcare Essential Plan 3&4	$53,984.16
Rate for Payer: United Healthcare Medicaid	$23,992.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,992.96

APR-DRG 6802: Major O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$68,013.70

Service Code	APR-DRG 6802
Min. Negotiated Rate	$23,968.00
Max. Negotiated Rate	$68,013.70
Rate for Payer: Affinity Essential Plan 1&2	$68,013.70
Rate for Payer: Affinity Essential Plan 3&4	$68,013.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$30,228.31
Rate for Payer: Amida Care Medicaid	$30,228.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,228.31
Rate for Payer: Fidelis Qualified Health Plan	$36,273.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,228.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,228.31
Rate for Payer: Healthfirst Commercial	$41,236.00
Rate for Payer: Healthfirst Essential Plan	$68,013.70
Rate for Payer: Healthfirst QHP	$23,968.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,228.31
Rate for Payer: SOMOS Essential	$68,013.70
Rate for Payer: United Healthcare Essential Plan 1&2	$68,013.70
Rate for Payer: United Healthcare Essential Plan 3&4	$68,013.70
Rate for Payer: United Healthcare Medicaid	$30,228.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,228.31

APR-DRG 6803: Major O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$97,683.73

Service Code	APR-DRG 6803
Min. Negotiated Rate	$43,414.99
Max. Negotiated Rate	$97,683.73
Rate for Payer: Affinity Essential Plan 1&2	$97,683.73
Rate for Payer: Affinity Essential Plan 3&4	$97,683.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$43,414.99
Rate for Payer: Amida Care Medicaid	$43,414.99
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,414.99
Rate for Payer: Fidelis Qualified Health Plan	$52,097.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,414.99
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,414.99
Rate for Payer: Healthfirst Commercial	$70,278.00
Rate for Payer: Healthfirst Essential Plan	$97,683.73
Rate for Payer: Healthfirst QHP	$46,133.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,414.99
Rate for Payer: SOMOS Essential	$97,683.73
Rate for Payer: United Healthcare Essential Plan 1&2	$97,683.73
Rate for Payer: United Healthcare Essential Plan 3&4	$97,683.73
Rate for Payer: United Healthcare Medicaid	$43,414.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,414.99

APR-DRG 6804: Major O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$191,719.00

Service Code	APR-DRG 6804
Min. Negotiated Rate	$83,104.82
Max. Negotiated Rate	$191,719.00
Rate for Payer: Affinity Essential Plan 1&2	$186,985.84
Rate for Payer: Affinity Essential Plan 3&4	$186,985.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$83,104.82
Rate for Payer: Amida Care Medicaid	$83,104.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$83,104.82
Rate for Payer: Fidelis Qualified Health Plan	$99,725.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$83,104.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$83,104.82
Rate for Payer: Healthfirst Commercial	$191,719.00
Rate for Payer: Healthfirst Essential Plan	$186,985.84
Rate for Payer: Healthfirst QHP	$121,742.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$83,104.82
Rate for Payer: SOMOS Essential	$186,985.84
Rate for Payer: United Healthcare Essential Plan 1&2	$186,985.84
Rate for Payer: United Healthcare Essential Plan 3&4	$186,985.84
Rate for Payer: United Healthcare Medicaid	$83,104.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$83,104.82

APR-DRG 6811: Other O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$46,319.56

Service Code	APR-DRG 6811
Min. Negotiated Rate	$11,907.00
Max. Negotiated Rate	$46,319.56
Rate for Payer: Affinity Essential Plan 1&2	$46,319.56
Rate for Payer: Affinity Essential Plan 3&4	$46,319.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,586.47
Rate for Payer: Amida Care Medicaid	$20,586.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,586.47
Rate for Payer: Fidelis Qualified Health Plan	$24,703.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,586.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,586.47
Rate for Payer: Healthfirst Commercial	$19,799.00
Rate for Payer: Healthfirst Essential Plan	$46,319.56
Rate for Payer: Healthfirst QHP	$11,907.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,586.47
Rate for Payer: SOMOS Essential	$46,319.56
Rate for Payer: United Healthcare Essential Plan 1&2	$46,319.56
Rate for Payer: United Healthcare Essential Plan 3&4	$46,319.56
Rate for Payer: United Healthcare Medicaid	$20,586.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,586.47

APR-DRG 6812: Other O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$57,528.04

Service Code	APR-DRG 6812
Min. Negotiated Rate	$18,158.00
Max. Negotiated Rate	$57,528.04
Rate for Payer: Affinity Essential Plan 1&2	$57,528.04
Rate for Payer: Affinity Essential Plan 3&4	$57,528.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,568.02
Rate for Payer: Amida Care Medicaid	$25,568.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,568.02
Rate for Payer: Fidelis Qualified Health Plan	$30,681.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,568.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,568.02
Rate for Payer: Healthfirst Commercial	$28,635.00
Rate for Payer: Healthfirst Essential Plan	$57,528.04
Rate for Payer: Healthfirst QHP	$18,158.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,568.02
Rate for Payer: SOMOS Essential	$57,528.04
Rate for Payer: United Healthcare Essential Plan 1&2	$57,528.04
Rate for Payer: United Healthcare Essential Plan 3&4	$57,528.04
Rate for Payer: United Healthcare Medicaid	$25,568.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,568.02

APR-DRG 6813: Other O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$96,814.91

Service Code	APR-DRG 6813
Min. Negotiated Rate	$37,043.00
Max. Negotiated Rate	$96,814.91
Rate for Payer: Affinity Essential Plan 1&2	$96,814.91
Rate for Payer: Affinity Essential Plan 3&4	$96,814.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$43,028.85
Rate for Payer: Amida Care Medicaid	$43,028.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,028.85
Rate for Payer: Fidelis Qualified Health Plan	$51,634.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,028.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,028.85
Rate for Payer: Healthfirst Commercial	$59,653.00
Rate for Payer: Healthfirst Essential Plan	$96,814.91
Rate for Payer: Healthfirst QHP	$37,043.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,028.85
Rate for Payer: SOMOS Essential	$96,814.91
Rate for Payer: United Healthcare Essential Plan 1&2	$96,814.91
Rate for Payer: United Healthcare Essential Plan 3&4	$96,814.91
Rate for Payer: United Healthcare Medicaid	$43,028.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,028.85

APR-DRG 6814: Other O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$187,423.76

Service Code	APR-DRG 6814
Min. Negotiated Rate	$83,299.45
Max. Negotiated Rate	$187,423.76
Rate for Payer: Affinity Essential Plan 1&2	$187,423.76
Rate for Payer: Affinity Essential Plan 3&4	$187,423.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$83,299.45
Rate for Payer: Amida Care Medicaid	$83,299.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$83,299.45
Rate for Payer: Fidelis Qualified Health Plan	$99,959.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$83,299.45
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$83,299.45
Rate for Payer: Healthfirst Commercial	$143,474.00
Rate for Payer: Healthfirst Essential Plan	$187,423.76
Rate for Payer: Healthfirst QHP	$93,926.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$83,299.45
Rate for Payer: SOMOS Essential	$187,423.76
Rate for Payer: United Healthcare Essential Plan 1&2	$187,423.76
Rate for Payer: United Healthcare Essential Plan 3&4	$187,423.76
Rate for Payer: United Healthcare Medicaid	$83,299.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$83,299.45

APR-DRG 6901: Acute leukemia

Facility

$53,152.29

Service Code	APR-DRG 6901
Min. Negotiated Rate	$15,442.00
Max. Negotiated Rate	$53,152.29
Rate for Payer: Affinity Essential Plan 1&2	$53,152.29
Rate for Payer: Affinity Essential Plan 3&4	$53,152.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,623.24
Rate for Payer: Amida Care Medicaid	$23,623.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,623.24
Rate for Payer: Fidelis Qualified Health Plan	$28,347.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,623.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,623.24
Rate for Payer: Healthfirst Commercial	$22,399.00
Rate for Payer: Healthfirst Essential Plan	$53,152.29
Rate for Payer: Healthfirst QHP	$15,442.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,623.24
Rate for Payer: SOMOS Essential	$53,152.29
Rate for Payer: United Healthcare Essential Plan 1&2	$53,152.29
Rate for Payer: United Healthcare Essential Plan 3&4	$53,152.29
Rate for Payer: United Healthcare Medicaid	$23,623.24
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,623.24

APR-DRG 6902: Acute leukemia

Facility

$77,458.16

Service Code	APR-DRG 6902
Min. Negotiated Rate	$31,706.00
Max. Negotiated Rate	$77,458.16
Rate for Payer: Affinity Essential Plan 1&2	$77,458.16
Rate for Payer: Affinity Essential Plan 3&4	$77,458.16
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,425.85
Rate for Payer: Amida Care Medicaid	$34,425.85
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,425.85
Rate for Payer: Fidelis Qualified Health Plan	$41,311.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,425.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,425.85
Rate for Payer: Healthfirst Commercial	$43,079.00
Rate for Payer: Healthfirst Essential Plan	$77,458.16
Rate for Payer: Healthfirst QHP	$31,706.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,425.85
Rate for Payer: SOMOS Essential	$77,458.16
Rate for Payer: United Healthcare Essential Plan 1&2	$77,458.16
Rate for Payer: United Healthcare Essential Plan 3&4	$77,458.16
Rate for Payer: United Healthcare Medicaid	$34,425.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,425.85

APR-DRG 6903: Acute leukemia

Facility

$136,274.15

Service Code	APR-DRG 6903
Min. Negotiated Rate	$60,566.29
Max. Negotiated Rate	$136,274.15
Rate for Payer: Affinity Essential Plan 1&2	$136,274.15
Rate for Payer: Affinity Essential Plan 3&4	$136,274.15
Rate for Payer: Affinity Medicaid/CHP/HARP	$60,566.29
Rate for Payer: Amida Care Medicaid	$60,566.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$60,566.29
Rate for Payer: Fidelis Qualified Health Plan	$72,679.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$60,566.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60,566.29
Rate for Payer: Healthfirst Commercial	$90,583.00
Rate for Payer: Healthfirst Essential Plan	$136,274.15
Rate for Payer: Healthfirst QHP	$62,704.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$60,566.29
Rate for Payer: SOMOS Essential	$136,274.15
Rate for Payer: United Healthcare Essential Plan 1&2	$136,274.15
Rate for Payer: United Healthcare Essential Plan 3&4	$136,274.15
Rate for Payer: United Healthcare Medicaid	$60,566.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$60,566.29

APR-DRG 6904: Acute leukemia

Facility

$183,587.94

Service Code	APR-DRG 6904
Min. Negotiated Rate	$81,594.64
Max. Negotiated Rate	$183,587.94
Rate for Payer: Affinity Essential Plan 1&2	$183,587.94
Rate for Payer: Affinity Essential Plan 3&4	$183,587.94
Rate for Payer: Affinity Medicaid/CHP/HARP	$81,594.64
Rate for Payer: Amida Care Medicaid	$81,594.64
Rate for Payer: Fidelis CHP/HARP/Medicaid	$81,594.64
Rate for Payer: Fidelis Qualified Health Plan	$97,913.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$81,594.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$81,594.64
Rate for Payer: Healthfirst Commercial	$161,483.00
Rate for Payer: Healthfirst Essential Plan	$183,587.94
Rate for Payer: Healthfirst QHP	$103,813.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$81,594.64
Rate for Payer: SOMOS Essential	$183,587.94
Rate for Payer: United Healthcare Essential Plan 1&2	$183,587.94
Rate for Payer: United Healthcare Essential Plan 3&4	$183,587.94
Rate for Payer: United Healthcare Medicaid	$81,594.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$81,594.64

APR-DRG 6911: Lymphoma, myeloma & non-acute leukemia

Facility

$47,629.82

Service Code	APR-DRG 6911
Min. Negotiated Rate	$10,891.00
Max. Negotiated Rate	$47,629.82
Rate for Payer: Affinity Essential Plan 1&2	$47,629.82
Rate for Payer: Affinity Essential Plan 3&4	$47,629.82
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,168.81
Rate for Payer: Amida Care Medicaid	$21,168.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,168.81
Rate for Payer: Fidelis Qualified Health Plan	$25,402.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,168.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,168.81
Rate for Payer: Healthfirst Commercial	$18,425.00
Rate for Payer: Healthfirst Essential Plan	$47,629.82
Rate for Payer: Healthfirst QHP	$10,891.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,168.81
Rate for Payer: SOMOS Essential	$47,629.82
Rate for Payer: United Healthcare Essential Plan 1&2	$47,629.82
Rate for Payer: United Healthcare Essential Plan 3&4	$47,629.82
Rate for Payer: United Healthcare Medicaid	$21,168.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,168.81

APR-DRG 6912: Lymphoma, myeloma & non-acute leukemia

Facility

$55,742.92

Service Code	APR-DRG 6912
Min. Negotiated Rate	$15,881.00
Max. Negotiated Rate	$55,742.92
Rate for Payer: Affinity Essential Plan 1&2	$55,742.92
Rate for Payer: Affinity Essential Plan 3&4	$55,742.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,774.63
Rate for Payer: Amida Care Medicaid	$24,774.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,774.63
Rate for Payer: Fidelis Qualified Health Plan	$29,729.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,774.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,774.63
Rate for Payer: Healthfirst Commercial	$25,363.00
Rate for Payer: Healthfirst Essential Plan	$55,742.92
Rate for Payer: Healthfirst QHP	$15,881.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,774.63
Rate for Payer: SOMOS Essential	$55,742.92
Rate for Payer: United Healthcare Essential Plan 1&2	$55,742.92
Rate for Payer: United Healthcare Essential Plan 3&4	$55,742.92
Rate for Payer: United Healthcare Medicaid	$24,774.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,774.63

APR-DRG 6913: Lymphoma, myeloma & non-acute leukemia

Facility

$73,835.14

Service Code	APR-DRG 6913
Min. Negotiated Rate	$26,441.00
Max. Negotiated Rate	$73,835.14
Rate for Payer: Affinity Essential Plan 1&2	$73,835.14
Rate for Payer: Affinity Essential Plan 3&4	$73,835.14
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,815.62
Rate for Payer: Amida Care Medicaid	$32,815.62
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,815.62
Rate for Payer: Fidelis Qualified Health Plan	$39,378.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,815.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,815.62
Rate for Payer: Healthfirst Commercial	$44,809.00
Rate for Payer: Healthfirst Essential Plan	$73,835.14
Rate for Payer: Healthfirst QHP	$26,441.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,815.62
Rate for Payer: SOMOS Essential	$73,835.14
Rate for Payer: United Healthcare Essential Plan 1&2	$73,835.14
Rate for Payer: United Healthcare Essential Plan 3&4	$73,835.14
Rate for Payer: United Healthcare Medicaid	$32,815.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,815.62

APR-DRG 6914: Lymphoma, myeloma & non-acute leukemia

Facility

$141,021.00

Service Code	APR-DRG 6914
Min. Negotiated Rate	$57,238.00
Max. Negotiated Rate	$141,021.00
Rate for Payer: Affinity Essential Plan 1&2	$141,021.00
Rate for Payer: Affinity Essential Plan 3&4	$141,021.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$62,676.00
Rate for Payer: Amida Care Medicaid	$62,676.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$62,676.00
Rate for Payer: Fidelis Qualified Health Plan	$75,211.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$62,676.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62,676.00
Rate for Payer: Healthfirst Commercial	$105,299.00
Rate for Payer: Healthfirst Essential Plan	$141,021.00
Rate for Payer: Healthfirst QHP	$57,238.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62,676.00
Rate for Payer: SOMOS Essential	$141,021.00
Rate for Payer: United Healthcare Essential Plan 1&2	$141,021.00
Rate for Payer: United Healthcare Essential Plan 3&4	$141,021.00
Rate for Payer: United Healthcare Medicaid	$62,676.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$62,676.00

APR-DRG 6921: Radiotherapy

Facility

$40,123.48

Service Code	APR-DRG 6921
Min. Negotiated Rate	$6,714.00
Max. Negotiated Rate	$40,123.48
Rate for Payer: Affinity Essential Plan 1&2	$40,123.48
Rate for Payer: Affinity Essential Plan 3&4	$40,123.48
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,832.66
Rate for Payer: Amida Care Medicaid	$17,832.66
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,832.66
Rate for Payer: Fidelis Qualified Health Plan	$21,399.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,832.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,832.66
Rate for Payer: Healthfirst Commercial	$11,685.00
Rate for Payer: Healthfirst Essential Plan	$40,123.48
Rate for Payer: Healthfirst QHP	$6,714.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,832.66
Rate for Payer: SOMOS Essential	$40,123.48
Rate for Payer: United Healthcare Essential Plan 1&2	$40,123.48
Rate for Payer: United Healthcare Essential Plan 3&4	$40,123.48
Rate for Payer: United Healthcare Medicaid	$17,832.66
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,832.66

APR-DRG 6922: Radiotherapy

Facility

$52,522.65

Service Code	APR-DRG 6922
Min. Negotiated Rate	$12,707.00
Max. Negotiated Rate	$52,522.65
Rate for Payer: Affinity Essential Plan 1&2	$52,522.65
Rate for Payer: Affinity Essential Plan 3&4	$52,522.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,343.40
Rate for Payer: Amida Care Medicaid	$23,343.40
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,343.40
Rate for Payer: Fidelis Qualified Health Plan	$28,012.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,343.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,343.40
Rate for Payer: Healthfirst Commercial	$20,705.00
Rate for Payer: Healthfirst Essential Plan	$52,522.65
Rate for Payer: Healthfirst QHP	$12,707.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,343.40
Rate for Payer: SOMOS Essential	$52,522.65
Rate for Payer: United Healthcare Essential Plan 1&2	$52,522.65
Rate for Payer: United Healthcare Essential Plan 3&4	$52,522.65
Rate for Payer: United Healthcare Medicaid	$23,343.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,343.40

APR-DRG 6923: Radiotherapy

Facility

$78,603.10

Service Code	APR-DRG 6923
Min. Negotiated Rate	$26,647.00
Max. Negotiated Rate	$78,603.10
Rate for Payer: Affinity Essential Plan 1&2	$78,603.10
Rate for Payer: Affinity Essential Plan 3&4	$78,603.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,934.71
Rate for Payer: Amida Care Medicaid	$34,934.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,934.71
Rate for Payer: Fidelis Qualified Health Plan	$41,921.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,934.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,934.71
Rate for Payer: Healthfirst Commercial	$46,446.00
Rate for Payer: Healthfirst Essential Plan	$78,603.10
Rate for Payer: Healthfirst QHP	$26,647.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,934.71
Rate for Payer: SOMOS Essential	$78,603.10
Rate for Payer: United Healthcare Essential Plan 1&2	$78,603.10
Rate for Payer: United Healthcare Essential Plan 3&4	$78,603.10
Rate for Payer: United Healthcare Medicaid	$34,934.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,934.71

APR-DRG 6924: Radiotherapy

Facility

$84,581.08

Service Code	APR-DRG 6924
Min. Negotiated Rate	$30,265.00
Max. Negotiated Rate	$84,581.08
Rate for Payer: Affinity Essential Plan 1&2	$84,581.08
Rate for Payer: Affinity Essential Plan 3&4	$84,581.08
Rate for Payer: Affinity Medicaid/CHP/HARP	$37,591.59
Rate for Payer: Amida Care Medicaid	$37,591.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,591.59
Rate for Payer: Fidelis Qualified Health Plan	$45,109.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,591.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,591.59
Rate for Payer: Healthfirst Commercial	$49,714.00
Rate for Payer: Healthfirst Essential Plan	$84,581.08
Rate for Payer: Healthfirst QHP	$30,265.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,591.59
Rate for Payer: SOMOS Essential	$84,581.08
Rate for Payer: United Healthcare Essential Plan 1&2	$84,581.08
Rate for Payer: United Healthcare Essential Plan 3&4	$84,581.08
Rate for Payer: United Healthcare Medicaid	$37,591.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,591.59

Know your out-of-pocket cost for care.

All Charges