St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COMPUTED TOMOGRAPHIC ANGIOGRAPHY

Facility

$657.90

Service Code	EAPG 00302
Min. Negotiated Rate	$476.75
Max. Negotiated Rate	$657.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$476.75
Rate for Payer: Healthfirst Commercial	$657.90

COMPUTED TOMOGRAPHY- OTHER

Facility

$466.18

Service Code	EAPG 00301
Min. Negotiated Rate	$337.89
Max. Negotiated Rate	$466.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$337.89
Rate for Payer: Healthfirst Commercial	$466.18

Concussion, closed skull Fx nos,uncomplicated intracranial injury, coma < 1 hr or no coma

Facility

$38,997.14

Service Code	APR-DRG 0571
Min. Negotiated Rate	$4,834.00
Max. Negotiated Rate	$38,997.14
Rate for Payer: Affinity Essential Plan 1&2	$38,997.14
Rate for Payer: Affinity Essential Plan 3&4	$38,997.14
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,332.06
Rate for Payer: Amida Care Medicaid	$17,332.06
Rate for Payer: EmblemHealth Essential Plan 1&2	$38,997.14
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,332.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,332.06
Rate for Payer: Fidelis Qualified Health Plan	$20,798.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,332.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,332.06
Rate for Payer: Healthfirst Commercial	$8,159.00
Rate for Payer: Healthfirst Essential Plan	$38,997.14
Rate for Payer: Healthfirst QHP	$4,834.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,332.06
Rate for Payer: SOMOS Essential	$38,997.14
Rate for Payer: United Healthcare Essential Plan 1&2	$38,997.14
Rate for Payer: United Healthcare Essential Plan 3&4	$38,997.14
Rate for Payer: United Healthcare Medicaid	$17,332.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,332.06

Concussion, closed skull Fx nos,uncomplicated intracranial injury, coma < 1 hr or no coma

Facility

$49,048.36

Service Code	APR-DRG 0573
Min. Negotiated Rate	$11,748.00
Max. Negotiated Rate	$49,048.36
Rate for Payer: Affinity Essential Plan 1&2	$49,048.36
Rate for Payer: Affinity Essential Plan 3&4	$49,048.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,799.27
Rate for Payer: Amida Care Medicaid	$21,799.27
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,048.36
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,799.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,799.27
Rate for Payer: Fidelis Qualified Health Plan	$26,159.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,799.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,799.27
Rate for Payer: Healthfirst Commercial	$19,940.00
Rate for Payer: Healthfirst Essential Plan	$49,048.36
Rate for Payer: Healthfirst QHP	$11,748.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,799.27
Rate for Payer: SOMOS Essential	$49,048.36
Rate for Payer: United Healthcare Essential Plan 1&2	$49,048.36
Rate for Payer: United Healthcare Essential Plan 3&4	$49,048.36
Rate for Payer: United Healthcare Medicaid	$21,799.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,799.27

Concussion, closed skull Fx nos,uncomplicated intracranial injury, coma < 1 hr or no coma

Facility

$41,512.14

Service Code	APR-DRG 0572
Min. Negotiated Rate	$6,441.00
Max. Negotiated Rate	$41,512.14
Rate for Payer: Affinity Essential Plan 1&2	$41,512.14
Rate for Payer: Affinity Essential Plan 3&4	$41,512.14
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,449.84
Rate for Payer: Amida Care Medicaid	$18,449.84
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,512.14
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,449.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,449.84
Rate for Payer: Fidelis Qualified Health Plan	$22,139.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,449.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,449.84
Rate for Payer: Healthfirst Commercial	$10,731.00
Rate for Payer: Healthfirst Essential Plan	$41,512.14
Rate for Payer: Healthfirst QHP	$6,441.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,449.84
Rate for Payer: SOMOS Essential	$41,512.14
Rate for Payer: United Healthcare Essential Plan 1&2	$41,512.14
Rate for Payer: United Healthcare Essential Plan 3&4	$41,512.14
Rate for Payer: United Healthcare Medicaid	$18,449.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,449.84

Concussion, closed skull Fx nos,uncomplicated intracranial injury, coma < 1 hr or no coma

Facility

$83,966.51

Service Code	APR-DRG 0574
Min. Negotiated Rate	$27,027.00
Max. Negotiated Rate	$83,966.51
Rate for Payer: Affinity Essential Plan 1&2	$83,966.51
Rate for Payer: Affinity Essential Plan 3&4	$83,966.51
Rate for Payer: Affinity Medicaid/CHP/HARP	$37,318.45
Rate for Payer: Amida Care Medicaid	$37,318.45
Rate for Payer: EmblemHealth Essential Plan 1&2	$83,966.51
Rate for Payer: EmblemHealth Essential Plan 3&4	$37,318.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,318.45
Rate for Payer: Fidelis Qualified Health Plan	$44,782.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,318.45
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,318.45
Rate for Payer: Healthfirst Commercial	$44,871.00
Rate for Payer: Healthfirst Essential Plan	$83,966.51
Rate for Payer: Healthfirst QHP	$27,027.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,318.45
Rate for Payer: SOMOS Essential	$83,966.51
Rate for Payer: United Healthcare Essential Plan 1&2	$83,966.51
Rate for Payer: United Healthcare Essential Plan 3&4	$83,966.51
Rate for Payer: United Healthcare Medicaid	$37,318.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,318.45

CONJUNCTIVITIS

Facility

$202.38

Service Code	EAPG 00555
Min. Negotiated Rate	$145.80
Max. Negotiated Rate	$202.38
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$145.80
Rate for Payer: Healthfirst Commercial	$202.38

CONNECTIVE TISSUE DIAGNOSES

Facility

$219.51

Service Code	EAPG 00655
Min. Negotiated Rate	$159.69
Max. Negotiated Rate	$219.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$159.69
Rate for Payer: Healthfirst Commercial	$219.51

Connective tissue disorders

Facility

$61,262.86

Service Code	APR-DRG 3463
Min. Negotiated Rate	$15,403.00
Max. Negotiated Rate	$61,262.86
Rate for Payer: Affinity Essential Plan 1&2	$61,262.86
Rate for Payer: Affinity Essential Plan 3&4	$61,262.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$27,227.94
Rate for Payer: Amida Care Medicaid	$27,227.94
Rate for Payer: EmblemHealth Essential Plan 1&2	$61,262.86
Rate for Payer: EmblemHealth Essential Plan 3&4	$27,227.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,227.94
Rate for Payer: Fidelis Qualified Health Plan	$32,673.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,227.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,227.94
Rate for Payer: Healthfirst Commercial	$27,520.00
Rate for Payer: Healthfirst Essential Plan	$61,262.86
Rate for Payer: Healthfirst QHP	$15,403.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,227.94
Rate for Payer: SOMOS Essential	$61,262.86
Rate for Payer: United Healthcare Essential Plan 1&2	$61,262.86
Rate for Payer: United Healthcare Essential Plan 3&4	$61,262.86
Rate for Payer: United Healthcare Medicaid	$27,227.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,227.94

Connective tissue disorders

Facility

$48,939.32

Service Code	APR-DRG 3462
Min. Negotiated Rate	$9,727.00
Max. Negotiated Rate	$48,939.32
Rate for Payer: Affinity Essential Plan 1&2	$48,939.32
Rate for Payer: Affinity Essential Plan 3&4	$48,939.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,750.81
Rate for Payer: Amida Care Medicaid	$21,750.81
Rate for Payer: EmblemHealth Essential Plan 1&2	$48,939.32
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,750.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,750.81
Rate for Payer: Fidelis Qualified Health Plan	$26,100.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,750.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,750.81
Rate for Payer: Healthfirst Commercial	$16,275.00
Rate for Payer: Healthfirst Essential Plan	$48,939.32
Rate for Payer: Healthfirst QHP	$9,727.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,750.81
Rate for Payer: SOMOS Essential	$48,939.32
Rate for Payer: United Healthcare Essential Plan 1&2	$48,939.32
Rate for Payer: United Healthcare Essential Plan 3&4	$48,939.32
Rate for Payer: United Healthcare Medicaid	$21,750.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,750.81

Connective tissue disorders

Facility

$117,746.75

Service Code	APR-DRG 3464
Min. Negotiated Rate	$37,345.00
Max. Negotiated Rate	$117,746.75
Rate for Payer: Affinity Essential Plan 1&2	$117,746.75
Rate for Payer: Affinity Essential Plan 3&4	$117,746.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$52,331.89
Rate for Payer: Amida Care Medicaid	$52,331.89
Rate for Payer: EmblemHealth Essential Plan 1&2	$117,746.75
Rate for Payer: EmblemHealth Essential Plan 3&4	$52,331.89
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52,331.89
Rate for Payer: Fidelis Qualified Health Plan	$62,798.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$52,331.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52,331.89
Rate for Payer: Healthfirst Commercial	$74,422.00
Rate for Payer: Healthfirst Essential Plan	$117,746.75
Rate for Payer: Healthfirst QHP	$37,345.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52,331.89
Rate for Payer: SOMOS Essential	$117,746.75
Rate for Payer: United Healthcare Essential Plan 1&2	$117,746.75
Rate for Payer: United Healthcare Essential Plan 3&4	$117,746.75
Rate for Payer: United Healthcare Medicaid	$52,331.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$52,331.89

Connective tissue disorders

Facility

$44,881.90

Service Code	APR-DRG 3461
Min. Negotiated Rate	$7,515.00
Max. Negotiated Rate	$44,881.90
Rate for Payer: Affinity Essential Plan 1&2	$44,881.90
Rate for Payer: Affinity Essential Plan 3&4	$44,881.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,947.51
Rate for Payer: Amida Care Medicaid	$19,947.51
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,881.90
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,947.51
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,947.51
Rate for Payer: Fidelis Qualified Health Plan	$23,937.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,947.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,947.51
Rate for Payer: Healthfirst Commercial	$12,396.00
Rate for Payer: Healthfirst Essential Plan	$44,881.90
Rate for Payer: Healthfirst QHP	$7,515.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,947.51
Rate for Payer: SOMOS Essential	$44,881.90
Rate for Payer: United Healthcare Essential Plan 1&2	$44,881.90
Rate for Payer: United Healthcare Essential Plan 3&4	$44,881.90
Rate for Payer: United Healthcare Medicaid	$19,947.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,947.51

CONSTIPATION

Facility

$270.60

Service Code	EAPG 00630
Min. Negotiated Rate	$196.72
Max. Negotiated Rate	$270.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$196.72
Rate for Payer: Healthfirst Commercial	$270.60

CONTRACEPTIVE MANAGEMENT

Facility

$399.89

Service Code	EAPG 00875
Min. Negotiated Rate	$377.23
Max. Negotiated Rate	$399.89
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$377.23
Rate for Payer: Healthfirst Commercial	$399.89

Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility

$39,276.76

Service Code	APR-DRG 3841
Min. Negotiated Rate	$4,944.00
Max. Negotiated Rate	$39,276.76
Rate for Payer: Affinity Essential Plan 1&2	$39,276.76
Rate for Payer: Affinity Essential Plan 3&4	$39,276.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,456.34
Rate for Payer: Amida Care Medicaid	$17,456.34
Rate for Payer: EmblemHealth Essential Plan 1&2	$39,276.76
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,456.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,456.34
Rate for Payer: Fidelis Qualified Health Plan	$20,947.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,456.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,456.34
Rate for Payer: Healthfirst Commercial	$8,588.00
Rate for Payer: Healthfirst Essential Plan	$39,276.76
Rate for Payer: Healthfirst QHP	$4,944.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,456.34
Rate for Payer: SOMOS Essential	$39,276.76
Rate for Payer: United Healthcare Essential Plan 1&2	$39,276.76
Rate for Payer: United Healthcare Essential Plan 3&4	$39,276.76
Rate for Payer: United Healthcare Medicaid	$17,456.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,456.34

Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility

$64,372.32

Service Code	APR-DRG 3844
Min. Negotiated Rate	$23,269.00
Max. Negotiated Rate	$64,372.32
Rate for Payer: Affinity Essential Plan 1&2	$64,372.32
Rate for Payer: Affinity Essential Plan 3&4	$64,372.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,609.92
Rate for Payer: Amida Care Medicaid	$28,609.92
Rate for Payer: EmblemHealth Essential Plan 1&2	$64,372.32
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,609.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,609.92
Rate for Payer: Fidelis Qualified Health Plan	$34,331.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,609.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,609.92
Rate for Payer: Healthfirst Commercial	$31,873.00
Rate for Payer: Healthfirst Essential Plan	$64,372.32
Rate for Payer: Healthfirst QHP	$23,269.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,609.92
Rate for Payer: SOMOS Essential	$64,372.32
Rate for Payer: United Healthcare Essential Plan 1&2	$64,372.32
Rate for Payer: United Healthcare Essential Plan 3&4	$64,372.32
Rate for Payer: United Healthcare Medicaid	$28,609.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,609.92

Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility

$49,836.29

Service Code	APR-DRG 3843
Min. Negotiated Rate	$10,183.00
Max. Negotiated Rate	$49,836.29
Rate for Payer: Affinity Essential Plan 1&2	$49,836.29
Rate for Payer: Affinity Essential Plan 3&4	$49,836.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,149.46
Rate for Payer: Amida Care Medicaid	$22,149.46
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,836.29
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,149.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,149.46
Rate for Payer: Fidelis Qualified Health Plan	$26,579.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,149.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,149.46
Rate for Payer: Healthfirst Commercial	$17,440.00
Rate for Payer: Healthfirst Essential Plan	$49,836.29
Rate for Payer: Healthfirst QHP	$10,183.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,149.46
Rate for Payer: SOMOS Essential	$49,836.29
Rate for Payer: United Healthcare Essential Plan 1&2	$49,836.29
Rate for Payer: United Healthcare Essential Plan 3&4	$49,836.29
Rate for Payer: United Healthcare Medicaid	$22,149.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,149.46

Contusion, open wound & other trauma to skin & subcutaneous tissue

Facility

$42,203.32

Service Code	APR-DRG 3842
Min. Negotiated Rate	$6,515.00
Max. Negotiated Rate	$42,203.32
Rate for Payer: Affinity Essential Plan 1&2	$42,203.32
Rate for Payer: Affinity Essential Plan 3&4	$42,203.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,757.03
Rate for Payer: Amida Care Medicaid	$18,757.03
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,203.32
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,757.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,757.03
Rate for Payer: Fidelis Qualified Health Plan	$22,508.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,757.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,757.03
Rate for Payer: Healthfirst Commercial	$11,307.00
Rate for Payer: Healthfirst Essential Plan	$42,203.32
Rate for Payer: Healthfirst QHP	$6,515.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,757.03
Rate for Payer: SOMOS Essential	$42,203.32
Rate for Payer: United Healthcare Essential Plan 1&2	$42,203.32
Rate for Payer: United Healthcare Essential Plan 3&4	$42,203.32
Rate for Payer: United Healthcare Medicaid	$18,757.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,757.03

CONTUSIONS TO EXTERNAL ORGANS OTHER THAN HEAD TRAUMA

Facility

$222.17

Service Code	EAPG 00610
Min. Negotiated Rate	$222.17
Max. Negotiated Rate	$222.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$222.17

CORNEAL TISSUE PROCESSING

Facility

$1,346.17

Service Code	EAPG 00485
Min. Negotiated Rate	$976.63
Max. Negotiated Rate	$1,346.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$976.63
Rate for Payer: Healthfirst Commercial	$1,346.17

Coronary bypass w AMI or complex PDX

Facility

$101,434.39

Service Code	APR-DRG 1652
Min. Negotiated Rate	$41,719.00
Max. Negotiated Rate	$101,434.39
Rate for Payer: Affinity Essential Plan 1&2	$101,434.39
Rate for Payer: Affinity Essential Plan 3&4	$101,434.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$45,081.95
Rate for Payer: Amida Care Medicaid	$45,081.95
Rate for Payer: EmblemHealth Essential Plan 1&2	$101,434.39
Rate for Payer: EmblemHealth Essential Plan 3&4	$45,081.95
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,081.95
Rate for Payer: Fidelis Qualified Health Plan	$54,098.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,081.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,081.95
Rate for Payer: Healthfirst Commercial	$68,870.00
Rate for Payer: Healthfirst Essential Plan	$101,434.39
Rate for Payer: Healthfirst QHP	$41,719.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,081.95
Rate for Payer: SOMOS Essential	$101,434.39
Rate for Payer: United Healthcare Essential Plan 1&2	$101,434.39
Rate for Payer: United Healthcare Essential Plan 3&4	$101,434.39
Rate for Payer: United Healthcare Medicaid	$45,081.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,081.95

Coronary bypass w AMI or complex PDX

Facility

$101,196.95

Service Code	APR-DRG 1651
Min. Negotiated Rate	$37,707.00
Max. Negotiated Rate	$101,196.95
Rate for Payer: Affinity Essential Plan 1&2	$101,196.95
Rate for Payer: Affinity Essential Plan 3&4	$101,196.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$44,976.42
Rate for Payer: Amida Care Medicaid	$44,976.42
Rate for Payer: EmblemHealth Essential Plan 1&2	$101,196.95
Rate for Payer: EmblemHealth Essential Plan 3&4	$44,976.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$44,976.42
Rate for Payer: Fidelis Qualified Health Plan	$53,971.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$44,976.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$44,976.42
Rate for Payer: Healthfirst Commercial	$60,839.00
Rate for Payer: Healthfirst Essential Plan	$101,196.95
Rate for Payer: Healthfirst QHP	$37,707.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$44,976.42
Rate for Payer: SOMOS Essential	$101,196.95
Rate for Payer: United Healthcare Essential Plan 1&2	$101,196.95
Rate for Payer: United Healthcare Essential Plan 3&4	$101,196.95
Rate for Payer: United Healthcare Medicaid	$44,976.42
Rate for Payer: Wellcare CHP/FHP/Medicaid	$44,976.42

Coronary bypass w AMI or complex PDX

Facility

$156,476.11

Service Code	APR-DRG 1654
Min. Negotiated Rate	$69,544.94
Max. Negotiated Rate	$156,476.11
Rate for Payer: Affinity Essential Plan 1&2	$156,476.11
Rate for Payer: Affinity Essential Plan 3&4	$156,476.11
Rate for Payer: Affinity Medicaid/CHP/HARP	$69,544.94
Rate for Payer: Amida Care Medicaid	$69,544.94
Rate for Payer: EmblemHealth Essential Plan 1&2	$156,476.11
Rate for Payer: EmblemHealth Essential Plan 3&4	$69,544.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$69,544.94
Rate for Payer: Fidelis Qualified Health Plan	$83,453.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$69,544.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$69,544.94
Rate for Payer: Healthfirst Commercial	$149,890.00
Rate for Payer: Healthfirst Essential Plan	$156,476.11
Rate for Payer: Healthfirst QHP	$80,090.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69,544.94
Rate for Payer: SOMOS Essential	$156,476.11
Rate for Payer: United Healthcare Essential Plan 1&2	$156,476.11
Rate for Payer: United Healthcare Essential Plan 3&4	$156,476.11
Rate for Payer: United Healthcare Medicaid	$69,544.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$69,544.94

Coronary bypass w AMI or complex PDX

Facility

$117,516.35

Service Code	APR-DRG 1653
Min. Negotiated Rate	$51,031.00
Max. Negotiated Rate	$117,516.35
Rate for Payer: Affinity Essential Plan 1&2	$117,516.35
Rate for Payer: Affinity Essential Plan 3&4	$117,516.35
Rate for Payer: Affinity Medicaid/CHP/HARP	$52,229.49
Rate for Payer: Amida Care Medicaid	$52,229.49
Rate for Payer: EmblemHealth Essential Plan 1&2	$117,516.35
Rate for Payer: EmblemHealth Essential Plan 3&4	$52,229.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52,229.49
Rate for Payer: Fidelis Qualified Health Plan	$62,675.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$52,229.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52,229.49
Rate for Payer: Healthfirst Commercial	$85,480.00
Rate for Payer: Healthfirst Essential Plan	$117,516.35
Rate for Payer: Healthfirst QHP	$51,031.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52,229.49
Rate for Payer: SOMOS Essential	$117,516.35
Rate for Payer: United Healthcare Essential Plan 1&2	$117,516.35
Rate for Payer: United Healthcare Essential Plan 3&4	$117,516.35
Rate for Payer: United Healthcare Medicaid	$52,229.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$52,229.49

Coronary bypass w/o AMI or complex PDX

Facility

$102,644.39

Service Code	APR-DRG 1663
Min. Negotiated Rate	$41,785.00
Max. Negotiated Rate	$102,644.39
Rate for Payer: Affinity Essential Plan 1&2	$102,644.39
Rate for Payer: Affinity Essential Plan 3&4	$102,644.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$45,619.73
Rate for Payer: Amida Care Medicaid	$45,619.73
Rate for Payer: EmblemHealth Essential Plan 1&2	$102,644.39
Rate for Payer: EmblemHealth Essential Plan 3&4	$45,619.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,619.73
Rate for Payer: Fidelis Qualified Health Plan	$54,743.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,619.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,619.73
Rate for Payer: Healthfirst Commercial	$75,699.00
Rate for Payer: Healthfirst Essential Plan	$102,644.39
Rate for Payer: Healthfirst QHP	$41,785.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,619.73
Rate for Payer: SOMOS Essential	$102,644.39
Rate for Payer: United Healthcare Essential Plan 1&2	$102,644.39
Rate for Payer: United Healthcare Essential Plan 3&4	$102,644.39
Rate for Payer: United Healthcare Medicaid	$45,619.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,619.73

Know your out-of-pocket cost for care.

All Charges