St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

APR-DRG 6941: Lymphatic & other malignancies & neoplasms of uncertain behavior

Facility

$40,594.84

Service Code	APR-DRG 6941
Min. Negotiated Rate	$6,419.00
Max. Negotiated Rate	$40,594.84
Rate for Payer: Affinity Essential Plan 1&2	$40,594.84
Rate for Payer: Affinity Essential Plan 3&4	$40,594.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,042.15
Rate for Payer: Amida Care Medicaid	$18,042.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,042.15
Rate for Payer: Fidelis Qualified Health Plan	$21,650.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,042.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,042.15
Rate for Payer: Healthfirst Commercial	$12,138.00
Rate for Payer: Healthfirst Essential Plan	$40,594.84
Rate for Payer: Healthfirst QHP	$6,419.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,042.15
Rate for Payer: SOMOS Essential	$40,594.84
Rate for Payer: United Healthcare Essential Plan 1&2	$40,594.84
Rate for Payer: United Healthcare Essential Plan 3&4	$40,594.84
Rate for Payer: United Healthcare Medicaid	$18,042.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,042.15

APR-DRG 6942: Lymphatic & other malignancies & neoplasms of uncertain behavior

Facility

$46,905.21

Service Code	APR-DRG 6942
Min. Negotiated Rate	$10,205.00
Max. Negotiated Rate	$46,905.21
Rate for Payer: Affinity Essential Plan 1&2	$46,905.21
Rate for Payer: Affinity Essential Plan 3&4	$46,905.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,846.76
Rate for Payer: Amida Care Medicaid	$20,846.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,846.76
Rate for Payer: Fidelis Qualified Health Plan	$25,016.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,846.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,846.76
Rate for Payer: Healthfirst Commercial	$14,870.00
Rate for Payer: Healthfirst Essential Plan	$46,905.21
Rate for Payer: Healthfirst QHP	$10,205.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,846.76
Rate for Payer: SOMOS Essential	$46,905.21
Rate for Payer: United Healthcare Essential Plan 1&2	$46,905.21
Rate for Payer: United Healthcare Essential Plan 3&4	$46,905.21
Rate for Payer: United Healthcare Medicaid	$20,846.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,846.76

APR-DRG 6943: Lymphatic & other malignancies & neoplasms of uncertain behavior

Facility

$58,150.64

Service Code	APR-DRG 6943
Min. Negotiated Rate	$16,448.00
Max. Negotiated Rate	$58,150.64
Rate for Payer: Affinity Essential Plan 1&2	$58,150.64
Rate for Payer: Affinity Essential Plan 3&4	$58,150.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,844.73
Rate for Payer: Amida Care Medicaid	$25,844.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,844.73
Rate for Payer: Fidelis Qualified Health Plan	$31,013.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,844.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,844.73
Rate for Payer: Healthfirst Commercial	$25,508.00
Rate for Payer: Healthfirst Essential Plan	$58,150.64
Rate for Payer: Healthfirst QHP	$16,448.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,844.73
Rate for Payer: SOMOS Essential	$58,150.64
Rate for Payer: United Healthcare Essential Plan 1&2	$58,150.64
Rate for Payer: United Healthcare Essential Plan 3&4	$58,150.64
Rate for Payer: United Healthcare Medicaid	$25,844.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,844.73

APR-DRG 6944: Lymphatic & other malignancies & neoplasms of uncertain behavior

Facility

$89,113.36

Service Code	APR-DRG 6944
Min. Negotiated Rate	$33,987.00
Max. Negotiated Rate	$89,113.36
Rate for Payer: Affinity Essential Plan 1&2	$89,113.36
Rate for Payer: Affinity Essential Plan 3&4	$89,113.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$39,605.94
Rate for Payer: Amida Care Medicaid	$39,605.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$39,605.94
Rate for Payer: Fidelis Qualified Health Plan	$47,527.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$39,605.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39,605.94
Rate for Payer: Healthfirst Commercial	$61,735.00
Rate for Payer: Healthfirst Essential Plan	$89,113.36
Rate for Payer: Healthfirst QHP	$33,987.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39,605.94
Rate for Payer: SOMOS Essential	$89,113.36
Rate for Payer: United Healthcare Essential Plan 1&2	$89,113.36
Rate for Payer: United Healthcare Essential Plan 3&4	$89,113.36
Rate for Payer: United Healthcare Medicaid	$39,605.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$39,605.94

APR-DRG 6951: Chemotherapy for acute leukemia #

Facility

$45,558.02

Service Code	APR-DRG 6951
Min. Negotiated Rate	$20,248.01
Max. Negotiated Rate	$45,558.02
Rate for Payer: Affinity Essential Plan 1&2	$45,558.02
Rate for Payer: Affinity Essential Plan 3&4	$45,558.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,248.01
Rate for Payer: Amida Care Medicaid	$20,248.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,248.01
Rate for Payer: Fidelis Qualified Health Plan	$24,297.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,248.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,248.01
Rate for Payer: Healthfirst Essential Plan	$45,558.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,248.01
Rate for Payer: SOMOS Essential	$45,558.02
Rate for Payer: United Healthcare Essential Plan 1&2	$45,558.02
Rate for Payer: United Healthcare Essential Plan 3&4	$45,558.02
Rate for Payer: United Healthcare Medicaid	$20,248.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,248.01

APR-DRG 6952: Chemotherapy for acute leukemia #

Facility

$45,580.88

Service Code	APR-DRG 6952
Min. Negotiated Rate	$20,258.17
Max. Negotiated Rate	$45,580.88
Rate for Payer: Affinity Essential Plan 1&2	$45,580.88
Rate for Payer: Affinity Essential Plan 3&4	$45,580.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,258.17
Rate for Payer: Amida Care Medicaid	$20,258.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,258.17
Rate for Payer: Fidelis Qualified Health Plan	$24,309.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,258.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,258.17
Rate for Payer: Healthfirst Essential Plan	$45,580.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,258.17
Rate for Payer: SOMOS Essential	$45,580.88
Rate for Payer: United Healthcare Essential Plan 1&2	$45,580.88
Rate for Payer: United Healthcare Essential Plan 3&4	$45,580.88
Rate for Payer: United Healthcare Medicaid	$20,258.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,258.17

APR-DRG 6953: Chemotherapy for acute leukemia #

Facility

$72,521.35

Service Code	APR-DRG 6953
Min. Negotiated Rate	$32,231.71
Max. Negotiated Rate	$72,521.35
Rate for Payer: Affinity Essential Plan 1&2	$72,521.35
Rate for Payer: Affinity Essential Plan 3&4	$72,521.35
Rate for Payer: Affinity Medicaid/CHP/HARP	$32,231.71
Rate for Payer: Amida Care Medicaid	$32,231.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,231.71
Rate for Payer: Fidelis Qualified Health Plan	$38,678.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,231.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,231.71
Rate for Payer: Healthfirst Essential Plan	$72,521.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,231.71
Rate for Payer: SOMOS Essential	$72,521.35
Rate for Payer: United Healthcare Essential Plan 1&2	$72,521.35
Rate for Payer: United Healthcare Essential Plan 3&4	$72,521.35
Rate for Payer: United Healthcare Medicaid	$32,231.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,231.71

APR-DRG 6954: Chemotherapy for acute leukemia #

Facility

$159,558.19

Service Code	APR-DRG 6954
Min. Negotiated Rate	$70,914.75
Max. Negotiated Rate	$159,558.19
Rate for Payer: Affinity Essential Plan 1&2	$159,558.19
Rate for Payer: Affinity Essential Plan 3&4	$159,558.19
Rate for Payer: Affinity Medicaid/CHP/HARP	$70,914.75
Rate for Payer: Amida Care Medicaid	$70,914.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$70,914.75
Rate for Payer: Fidelis Qualified Health Plan	$85,097.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$70,914.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$70,914.75
Rate for Payer: Healthfirst Essential Plan	$159,558.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70,914.75
Rate for Payer: SOMOS Essential	$159,558.19
Rate for Payer: United Healthcare Essential Plan 1&2	$159,558.19
Rate for Payer: United Healthcare Essential Plan 3&4	$159,558.19
Rate for Payer: United Healthcare Medicaid	$70,914.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$70,914.75

APR-DRG 6961: Other Chemotherapy #

Facility

$42,779.20

Service Code	APR-DRG 6961
Min. Negotiated Rate	$19,012.98
Max. Negotiated Rate	$42,779.20
Rate for Payer: Affinity Essential Plan 1&2	$42,779.20
Rate for Payer: Affinity Essential Plan 3&4	$42,779.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,012.98
Rate for Payer: Amida Care Medicaid	$19,012.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,012.98
Rate for Payer: Fidelis Qualified Health Plan	$22,815.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,012.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,012.98
Rate for Payer: Healthfirst Essential Plan	$42,779.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,012.98
Rate for Payer: SOMOS Essential	$42,779.20
Rate for Payer: United Healthcare Essential Plan 1&2	$42,779.20
Rate for Payer: United Healthcare Essential Plan 3&4	$42,779.20
Rate for Payer: United Healthcare Medicaid	$19,012.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,012.98

APR-DRG 6962: Other Chemotherapy #

Facility

$47,307.96

Service Code	APR-DRG 6962
Min. Negotiated Rate	$21,025.76
Max. Negotiated Rate	$47,307.96
Rate for Payer: Affinity Essential Plan 1&2	$47,307.96
Rate for Payer: Affinity Essential Plan 3&4	$47,307.96
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,025.76
Rate for Payer: Amida Care Medicaid	$21,025.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,025.76
Rate for Payer: Fidelis Qualified Health Plan	$25,230.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,025.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,025.76
Rate for Payer: Healthfirst Essential Plan	$47,307.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,025.76
Rate for Payer: SOMOS Essential	$47,307.96
Rate for Payer: United Healthcare Essential Plan 1&2	$47,307.96
Rate for Payer: United Healthcare Essential Plan 3&4	$47,307.96
Rate for Payer: United Healthcare Medicaid	$21,025.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,025.76

APR-DRG 6963: Other Chemotherapy #

Facility

$56,288.12

Service Code	APR-DRG 6963
Min. Negotiated Rate	$25,016.94
Max. Negotiated Rate	$56,288.12
Rate for Payer: Affinity Essential Plan 1&2	$56,288.12
Rate for Payer: Affinity Essential Plan 3&4	$56,288.12
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,016.94
Rate for Payer: Amida Care Medicaid	$25,016.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,016.94
Rate for Payer: Fidelis Qualified Health Plan	$30,020.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,016.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,016.94
Rate for Payer: Healthfirst Essential Plan	$56,288.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,016.94
Rate for Payer: SOMOS Essential	$56,288.12
Rate for Payer: United Healthcare Essential Plan 1&2	$56,288.12
Rate for Payer: United Healthcare Essential Plan 3&4	$56,288.12
Rate for Payer: United Healthcare Medicaid	$25,016.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,016.94

APR-DRG 6964: Other Chemotherapy #

Facility

$106,929.47

Service Code	APR-DRG 6964
Min. Negotiated Rate	$47,524.21
Max. Negotiated Rate	$106,929.47
Rate for Payer: Affinity Essential Plan 1&2	$106,929.47
Rate for Payer: Affinity Essential Plan 3&4	$106,929.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$47,524.21
Rate for Payer: Amida Care Medicaid	$47,524.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$47,524.21
Rate for Payer: Fidelis Qualified Health Plan	$57,029.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$47,524.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$47,524.21
Rate for Payer: Healthfirst Essential Plan	$106,929.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47,524.21
Rate for Payer: SOMOS Essential	$106,929.47
Rate for Payer: United Healthcare Essential Plan 1&2	$106,929.47
Rate for Payer: United Healthcare Essential Plan 3&4	$106,929.47
Rate for Payer: United Healthcare Medicaid	$47,524.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$47,524.21

APR-DRG 7101: Infectious & parasitic diseases including HIV w O.R. procedure

Facility

$48,706.18

Service Code	APR-DRG 7101
Min. Negotiated Rate	$13,829.00
Max. Negotiated Rate	$48,706.18
Rate for Payer: Affinity Essential Plan 1&2	$48,706.18
Rate for Payer: Affinity Essential Plan 3&4	$48,706.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,647.19
Rate for Payer: Amida Care Medicaid	$21,647.19
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,647.19
Rate for Payer: Fidelis Qualified Health Plan	$25,976.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,647.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,647.19
Rate for Payer: Healthfirst Commercial	$21,135.00
Rate for Payer: Healthfirst Essential Plan	$48,706.18
Rate for Payer: Healthfirst QHP	$13,829.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,647.19
Rate for Payer: SOMOS Essential	$48,706.18
Rate for Payer: United Healthcare Essential Plan 1&2	$48,706.18
Rate for Payer: United Healthcare Essential Plan 3&4	$48,706.18
Rate for Payer: United Healthcare Medicaid	$21,647.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,647.19

APR-DRG 7102: Infectious & parasitic diseases including HIV w O.R. procedure

Facility

$58,945.59

Service Code	APR-DRG 7102
Min. Negotiated Rate	$20,918.00
Max. Negotiated Rate	$58,945.59
Rate for Payer: Affinity Essential Plan 1&2	$58,945.59
Rate for Payer: Affinity Essential Plan 3&4	$58,945.59
Rate for Payer: Affinity Medicaid/CHP/HARP	$26,198.04
Rate for Payer: Amida Care Medicaid	$26,198.04
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,198.04
Rate for Payer: Fidelis Qualified Health Plan	$31,437.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,198.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,198.04
Rate for Payer: Healthfirst Commercial	$32,101.00
Rate for Payer: Healthfirst Essential Plan	$58,945.59
Rate for Payer: Healthfirst QHP	$20,918.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,198.04
Rate for Payer: SOMOS Essential	$58,945.59
Rate for Payer: United Healthcare Essential Plan 1&2	$58,945.59
Rate for Payer: United Healthcare Essential Plan 3&4	$58,945.59
Rate for Payer: United Healthcare Medicaid	$26,198.04
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,198.04

APR-DRG 7103: Infectious & parasitic diseases including HIV w O.R. procedure

Facility

$81,976.36

Service Code	APR-DRG 7103
Min. Negotiated Rate	$34,007.00
Max. Negotiated Rate	$81,976.36
Rate for Payer: Affinity Essential Plan 1&2	$81,976.36
Rate for Payer: Affinity Essential Plan 3&4	$81,976.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$36,433.94
Rate for Payer: Amida Care Medicaid	$36,433.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,433.94
Rate for Payer: Fidelis Qualified Health Plan	$43,720.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,433.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,433.94
Rate for Payer: Healthfirst Commercial	$57,396.00
Rate for Payer: Healthfirst Essential Plan	$81,976.36
Rate for Payer: Healthfirst QHP	$34,007.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,433.94
Rate for Payer: SOMOS Essential	$81,976.36
Rate for Payer: United Healthcare Essential Plan 1&2	$81,976.36
Rate for Payer: United Healthcare Essential Plan 3&4	$81,976.36
Rate for Payer: United Healthcare Medicaid	$36,433.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,433.94

APR-DRG 7104: Infectious & parasitic diseases including HIV w O.R. procedure

Facility

$140,802.91

Service Code	APR-DRG 7104
Min. Negotiated Rate	$62,579.07
Max. Negotiated Rate	$140,802.91
Rate for Payer: Affinity Essential Plan 1&2	$140,802.91
Rate for Payer: Affinity Essential Plan 3&4	$140,802.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$62,579.07
Rate for Payer: Amida Care Medicaid	$62,579.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$62,579.07
Rate for Payer: Fidelis Qualified Health Plan	$75,094.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$62,579.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62,579.07
Rate for Payer: Healthfirst Commercial	$118,890.00
Rate for Payer: Healthfirst Essential Plan	$140,802.91
Rate for Payer: Healthfirst QHP	$73,404.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62,579.07
Rate for Payer: SOMOS Essential	$140,802.91
Rate for Payer: United Healthcare Essential Plan 1&2	$140,802.91
Rate for Payer: United Healthcare Essential Plan 3&4	$140,802.91
Rate for Payer: United Healthcare Medicaid	$62,579.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$62,579.07

APR-DRG 7111: Post-op, post-trauma, other device infections w O.R. procedure

Facility

$50,014.69

Service Code	APR-DRG 7111
Min. Negotiated Rate	$13,367.00
Max. Negotiated Rate	$50,014.69
Rate for Payer: Affinity Essential Plan 1&2	$50,014.69
Rate for Payer: Affinity Essential Plan 3&4	$50,014.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,228.75
Rate for Payer: Amida Care Medicaid	$22,228.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,228.75
Rate for Payer: Fidelis Qualified Health Plan	$26,674.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,228.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,228.75
Rate for Payer: Healthfirst Commercial	$23,671.00
Rate for Payer: Healthfirst Essential Plan	$50,014.69
Rate for Payer: Healthfirst QHP	$13,367.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,228.75
Rate for Payer: SOMOS Essential	$50,014.69
Rate for Payer: United Healthcare Essential Plan 1&2	$50,014.69
Rate for Payer: United Healthcare Essential Plan 3&4	$50,014.69
Rate for Payer: United Healthcare Medicaid	$22,228.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,228.75

APR-DRG 7112: Post-op, post-trauma, other device infections w O.R. procedure

Facility

$57,510.45

Service Code	APR-DRG 7112
Min. Negotiated Rate	$19,465.00
Max. Negotiated Rate	$57,510.45
Rate for Payer: Affinity Essential Plan 1&2	$57,510.45
Rate for Payer: Affinity Essential Plan 3&4	$57,510.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,560.20
Rate for Payer: Amida Care Medicaid	$25,560.20
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,560.20
Rate for Payer: Fidelis Qualified Health Plan	$30,672.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,560.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,560.20
Rate for Payer: Healthfirst Commercial	$32,819.00
Rate for Payer: Healthfirst Essential Plan	$57,510.45
Rate for Payer: Healthfirst QHP	$19,465.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,560.20
Rate for Payer: SOMOS Essential	$57,510.45
Rate for Payer: United Healthcare Essential Plan 1&2	$57,510.45
Rate for Payer: United Healthcare Essential Plan 3&4	$57,510.45
Rate for Payer: United Healthcare Medicaid	$25,560.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,560.20

APR-DRG 7113: Post-op, post-trauma, other device infections w O.R. procedure

Facility

$80,205.32

Service Code	APR-DRG 7113
Min. Negotiated Rate	$33,692.00
Max. Negotiated Rate	$80,205.32
Rate for Payer: Affinity Essential Plan 1&2	$80,205.32
Rate for Payer: Affinity Essential Plan 3&4	$80,205.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,646.81
Rate for Payer: Amida Care Medicaid	$35,646.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,646.81
Rate for Payer: Fidelis Qualified Health Plan	$42,776.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,646.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,646.81
Rate for Payer: Healthfirst Commercial	$57,459.00
Rate for Payer: Healthfirst Essential Plan	$80,205.32
Rate for Payer: Healthfirst QHP	$33,692.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,646.81
Rate for Payer: SOMOS Essential	$80,205.32
Rate for Payer: United Healthcare Essential Plan 1&2	$80,205.32
Rate for Payer: United Healthcare Essential Plan 3&4	$80,205.32
Rate for Payer: United Healthcare Medicaid	$35,646.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,646.81

APR-DRG 7114: Post-op, post-trauma, other device infections w O.R. procedure

Facility

$135,799.29

Service Code	APR-DRG 7114
Min. Negotiated Rate	$60,355.24
Max. Negotiated Rate	$135,799.29
Rate for Payer: Affinity Essential Plan 1&2	$135,799.29
Rate for Payer: Affinity Essential Plan 3&4	$135,799.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$60,355.24
Rate for Payer: Amida Care Medicaid	$60,355.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$60,355.24
Rate for Payer: Fidelis Qualified Health Plan	$72,426.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$60,355.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60,355.24
Rate for Payer: Healthfirst Commercial	$118,117.00
Rate for Payer: Healthfirst Essential Plan	$135,799.29
Rate for Payer: Healthfirst QHP	$72,861.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$60,355.24
Rate for Payer: SOMOS Essential	$135,799.29
Rate for Payer: United Healthcare Essential Plan 1&2	$135,799.29
Rate for Payer: United Healthcare Essential Plan 3&4	$135,799.29
Rate for Payer: United Healthcare Medicaid	$60,355.24
Rate for Payer: Wellcare CHP/FHP/Medicaid	$60,355.24

APR-DRG 7201: Septicemia & disseminated infections

Facility

$40,272.98

Service Code	APR-DRG 7201
Min. Negotiated Rate	$7,406.00
Max. Negotiated Rate	$40,272.98
Rate for Payer: Affinity Essential Plan 1&2	$40,272.98
Rate for Payer: Affinity Essential Plan 3&4	$40,272.98
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,899.10
Rate for Payer: Amida Care Medicaid	$17,899.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,899.10
Rate for Payer: Fidelis Qualified Health Plan	$21,478.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,899.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,899.10
Rate for Payer: Healthfirst Commercial	$12,017.00
Rate for Payer: Healthfirst Essential Plan	$40,272.98
Rate for Payer: Healthfirst QHP	$7,406.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,899.10
Rate for Payer: SOMOS Essential	$40,272.98
Rate for Payer: United Healthcare Essential Plan 1&2	$40,272.98
Rate for Payer: United Healthcare Essential Plan 3&4	$40,272.98
Rate for Payer: United Healthcare Medicaid	$17,899.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,899.10

APR-DRG 7202: Septicemia & disseminated infections

Facility

$44,305.78

Service Code	APR-DRG 7202
Min. Negotiated Rate	$9,799.00
Max. Negotiated Rate	$44,305.78
Rate for Payer: Affinity Essential Plan 1&2	$44,305.78
Rate for Payer: Affinity Essential Plan 3&4	$44,305.78
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,691.46
Rate for Payer: Amida Care Medicaid	$19,691.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,691.46
Rate for Payer: Fidelis Qualified Health Plan	$23,629.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,691.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,691.46
Rate for Payer: Healthfirst Commercial	$16,121.00
Rate for Payer: Healthfirst Essential Plan	$44,305.78
Rate for Payer: Healthfirst QHP	$9,799.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,691.46
Rate for Payer: SOMOS Essential	$44,305.78
Rate for Payer: United Healthcare Essential Plan 1&2	$44,305.78
Rate for Payer: United Healthcare Essential Plan 3&4	$44,305.78
Rate for Payer: United Healthcare Medicaid	$19,691.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,691.46

APR-DRG 7203: Septicemia & disseminated infections

Facility

$55,813.28

Service Code	APR-DRG 7203
Min. Negotiated Rate	$15,024.00
Max. Negotiated Rate	$55,813.28
Rate for Payer: Affinity Essential Plan 1&2	$55,813.28
Rate for Payer: Affinity Essential Plan 3&4	$55,813.28
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,805.90
Rate for Payer: Amida Care Medicaid	$24,805.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,805.90
Rate for Payer: Fidelis Qualified Health Plan	$29,767.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,805.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,805.90
Rate for Payer: Healthfirst Commercial	$25,794.00
Rate for Payer: Healthfirst Essential Plan	$55,813.28
Rate for Payer: Healthfirst QHP	$15,024.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,805.90
Rate for Payer: SOMOS Essential	$55,813.28
Rate for Payer: United Healthcare Essential Plan 1&2	$55,813.28
Rate for Payer: United Healthcare Essential Plan 3&4	$55,813.28
Rate for Payer: United Healthcare Medicaid	$24,805.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,805.90

APR-DRG 7204: Septicemia & disseminated infections

Facility

$85,928.26

Service Code	APR-DRG 7204
Min. Negotiated Rate	$29,823.00
Max. Negotiated Rate	$85,928.26
Rate for Payer: Affinity Essential Plan 1&2	$85,928.26
Rate for Payer: Affinity Essential Plan 3&4	$85,928.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$38,190.34
Rate for Payer: Amida Care Medicaid	$38,190.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$38,190.34
Rate for Payer: Fidelis Qualified Health Plan	$45,828.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$38,190.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38,190.34
Rate for Payer: Healthfirst Commercial	$51,609.00
Rate for Payer: Healthfirst Essential Plan	$85,928.26
Rate for Payer: Healthfirst QHP	$29,823.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,190.34
Rate for Payer: SOMOS Essential	$85,928.26
Rate for Payer: United Healthcare Essential Plan 1&2	$85,928.26
Rate for Payer: United Healthcare Essential Plan 3&4	$85,928.26
Rate for Payer: United Healthcare Medicaid	$38,190.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$38,190.34

APR-DRG 7211: Post-operative, post-traumatic, other device infections

Facility

$40,965.93

Service Code	APR-DRG 7211
Min. Negotiated Rate	$7,328.00
Max. Negotiated Rate	$40,965.93
Rate for Payer: Affinity Essential Plan 1&2	$40,965.93
Rate for Payer: Affinity Essential Plan 3&4	$40,965.93
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,207.08
Rate for Payer: Amida Care Medicaid	$18,207.08
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,207.08
Rate for Payer: Fidelis Qualified Health Plan	$21,848.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,207.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,207.08
Rate for Payer: Healthfirst Commercial	$12,655.00
Rate for Payer: Healthfirst Essential Plan	$40,965.93
Rate for Payer: Healthfirst QHP	$7,328.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,207.08
Rate for Payer: SOMOS Essential	$40,965.93
Rate for Payer: United Healthcare Essential Plan 1&2	$40,965.93
Rate for Payer: United Healthcare Essential Plan 3&4	$40,965.93
Rate for Payer: United Healthcare Medicaid	$18,207.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,207.08

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