|
Major larynx & trachea procedures
|
Facility
|
IP
|
$229,530.92
|
|
|
Service Code
|
APR-DRG 0904
|
| Min. Negotiated Rate |
$56,520.00 |
| Max. Negotiated Rate |
$229,530.92 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$229,530.92
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$229,530.92
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$102,013.74
|
| Rate for Payer: Amida Care Medicaid |
$102,013.74
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$229,530.92
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$102,013.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$102,013.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$122,416.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$102,013.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$102,013.74
|
| Rate for Payer: Healthfirst Commercial |
$93,589.00
|
| Rate for Payer: Healthfirst Essential Plan |
$229,530.92
|
| Rate for Payer: Healthfirst QHP |
$56,520.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$102,013.74
|
| Rate for Payer: SOMOS Essential |
$229,530.92
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$229,530.92
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$229,530.92
|
| Rate for Payer: United Healthcare Medicaid |
$102,013.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$102,013.74
|
|
|
Major male pelvic procedures
|
Facility
|
IP
|
$54,076.61
|
|
|
Service Code
|
APR-DRG 4802
|
| Min. Negotiated Rate |
$12,489.00 |
| Max. Negotiated Rate |
$54,076.61 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$54,076.61
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$54,076.61
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24,034.05
|
| Rate for Payer: Amida Care Medicaid |
$24,034.05
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$54,076.61
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$24,034.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,034.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,840.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,034.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,034.05
|
| Rate for Payer: Healthfirst Commercial |
$21,533.00
|
| Rate for Payer: Healthfirst Essential Plan |
$54,076.61
|
| Rate for Payer: Healthfirst QHP |
$12,489.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,034.05
|
| Rate for Payer: SOMOS Essential |
$54,076.61
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$54,076.61
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$54,076.61
|
| Rate for Payer: United Healthcare Medicaid |
$24,034.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,034.05
|
|
|
Major male pelvic procedures
|
Facility
|
IP
|
$77,700.10
|
|
|
Service Code
|
APR-DRG 4804
|
| Min. Negotiated Rate |
$22,769.00 |
| Max. Negotiated Rate |
$77,700.10 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$77,700.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$77,700.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,533.38
|
| Rate for Payer: Amida Care Medicaid |
$34,533.38
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$77,700.10
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,533.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,533.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,440.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,533.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,533.38
|
| Rate for Payer: Healthfirst Commercial |
$46,549.00
|
| Rate for Payer: Healthfirst Essential Plan |
$77,700.10
|
| Rate for Payer: Healthfirst QHP |
$22,769.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,533.38
|
| Rate for Payer: SOMOS Essential |
$77,700.10
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$77,700.10
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$77,700.10
|
| Rate for Payer: United Healthcare Medicaid |
$34,533.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,533.38
|
|
|
Major male pelvic procedures
|
Facility
|
IP
|
$51,338.25
|
|
|
Service Code
|
APR-DRG 4801
|
| Min. Negotiated Rate |
$11,471.00 |
| Max. Negotiated Rate |
$51,338.25 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,338.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,338.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,817.00
|
| Rate for Payer: Amida Care Medicaid |
$22,817.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,338.25
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,817.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,817.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,380.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,817.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,817.00
|
| Rate for Payer: Healthfirst Commercial |
$18,982.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,338.25
|
| Rate for Payer: Healthfirst QHP |
$11,471.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,817.00
|
| Rate for Payer: SOMOS Essential |
$51,338.25
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,338.25
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,338.25
|
| Rate for Payer: United Healthcare Medicaid |
$22,817.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,817.00
|
|
|
Major male pelvic procedures
|
Facility
|
IP
|
$69,958.10
|
|
|
Service Code
|
APR-DRG 4803
|
| Min. Negotiated Rate |
$19,984.00 |
| Max. Negotiated Rate |
$69,958.10 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$69,958.10
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$69,958.10
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31,092.49
|
| Rate for Payer: Amida Care Medicaid |
$31,092.49
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$69,958.10
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$31,092.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31,092.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37,310.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31,092.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31,092.49
|
| Rate for Payer: Healthfirst Commercial |
$39,094.00
|
| Rate for Payer: Healthfirst Essential Plan |
$69,958.10
|
| Rate for Payer: Healthfirst QHP |
$19,984.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31,092.49
|
| Rate for Payer: SOMOS Essential |
$69,958.10
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$69,958.10
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$69,958.10
|
| Rate for Payer: United Healthcare Medicaid |
$31,092.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$31,092.49
|
|
|
MAJOR OPEN ABDOMINAL AND THORACIC VASCULAR PROCEDURES
|
Facility
|
OP
|
$3,228.45
|
|
|
Service Code
|
EAPG 00106
|
| Min. Negotiated Rate |
$3,228.45 |
| Max. Negotiated Rate |
$3,228.45 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,228.45
|
|
|
Major O.R. procedures for lymphatic/hematopoietic/other neoplasms
|
Facility
|
IP
|
$56,357.71
|
|
|
Service Code
|
APR-DRG 6801
|
| Min. Negotiated Rate |
$16,208.00 |
| Max. Negotiated Rate |
$56,357.71 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$56,357.71
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$56,357.71
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,047.87
|
| Rate for Payer: Amida Care Medicaid |
$25,047.87
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$56,357.71
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,047.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,047.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30,057.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,047.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,047.87
|
| Rate for Payer: Healthfirst Commercial |
$26,132.00
|
| Rate for Payer: Healthfirst Essential Plan |
$56,357.71
|
| Rate for Payer: Healthfirst QHP |
$16,208.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,047.87
|
| Rate for Payer: SOMOS Essential |
$56,357.71
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$56,357.71
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$56,357.71
|
| Rate for Payer: United Healthcare Medicaid |
$25,047.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,047.87
|
|
|
Major O.R. procedures for lymphatic/hematopoietic/other neoplasms
|
Facility
|
IP
|
$100,057.27
|
|
|
Service Code
|
APR-DRG 6803
|
| Min. Negotiated Rate |
$44,469.90 |
| Max. Negotiated Rate |
$100,057.27 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$100,057.27
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$100,057.27
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$44,469.90
|
| Rate for Payer: Amida Care Medicaid |
$44,469.90
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$100,057.27
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$44,469.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$44,469.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$53,363.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$44,469.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44,469.90
|
| Rate for Payer: Healthfirst Commercial |
$70,278.00
|
| Rate for Payer: Healthfirst Essential Plan |
$100,057.27
|
| Rate for Payer: Healthfirst QHP |
$46,133.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44,469.90
|
| Rate for Payer: SOMOS Essential |
$100,057.27
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$100,057.27
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$100,057.27
|
| Rate for Payer: United Healthcare Medicaid |
$44,469.90
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$44,469.90
|
|
|
Major O.R. procedures for lymphatic/hematopoietic/other neoplasms
|
Facility
|
IP
|
$70,387.24
|
|
|
Service Code
|
APR-DRG 6802
|
| Min. Negotiated Rate |
$23,968.00 |
| Max. Negotiated Rate |
$70,387.24 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$70,387.24
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$70,387.24
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31,283.22
|
| Rate for Payer: Amida Care Medicaid |
$31,283.22
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$70,387.24
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$31,283.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31,283.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37,539.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31,283.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31,283.22
|
| Rate for Payer: Healthfirst Commercial |
$41,236.00
|
| Rate for Payer: Healthfirst Essential Plan |
$70,387.24
|
| Rate for Payer: Healthfirst QHP |
$23,968.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31,283.22
|
| Rate for Payer: SOMOS Essential |
$70,387.24
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$70,387.24
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$70,387.24
|
| Rate for Payer: United Healthcare Medicaid |
$31,283.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$31,283.22
|
|
|
Major O.R. procedures for lymphatic/hematopoietic/other neoplasms
|
Facility
|
IP
|
$191,719.00
|
|
|
Service Code
|
APR-DRG 6804
|
| Min. Negotiated Rate |
$84,159.73 |
| Max. Negotiated Rate |
$191,719.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$189,359.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$189,359.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$84,159.73
|
| Rate for Payer: Amida Care Medicaid |
$84,159.73
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$189,359.39
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$84,159.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$84,159.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$100,991.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$84,159.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$84,159.73
|
| Rate for Payer: Healthfirst Commercial |
$191,719.00
|
| Rate for Payer: Healthfirst Essential Plan |
$189,359.39
|
| Rate for Payer: Healthfirst QHP |
$121,742.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$84,159.73
|
| Rate for Payer: SOMOS Essential |
$189,359.39
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$189,359.39
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$189,359.39
|
| Rate for Payer: United Healthcare Medicaid |
$84,159.73
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$84,159.73
|
|
|
Major pancreas, liver & shunt procedures
|
Facility
|
IP
|
$87,332.76
|
|
|
Service Code
|
APR-DRG 2603
|
| Min. Negotiated Rate |
$38,127.00 |
| Max. Negotiated Rate |
$87,332.76 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$87,332.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$87,332.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$38,814.56
|
| Rate for Payer: Amida Care Medicaid |
$38,814.56
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$87,332.76
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$38,814.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38,814.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$46,577.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38,814.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38,814.56
|
| Rate for Payer: Healthfirst Commercial |
$59,831.00
|
| Rate for Payer: Healthfirst Essential Plan |
$87,332.76
|
| Rate for Payer: Healthfirst QHP |
$38,127.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38,814.56
|
| Rate for Payer: SOMOS Essential |
$87,332.76
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$87,332.76
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$87,332.76
|
| Rate for Payer: United Healthcare Medicaid |
$38,814.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$38,814.56
|
|
|
Major pancreas, liver & shunt procedures
|
Facility
|
IP
|
$57,690.86
|
|
|
Service Code
|
APR-DRG 2601
|
| Min. Negotiated Rate |
$17,534.00 |
| Max. Negotiated Rate |
$57,690.86 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$57,690.86
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$57,690.86
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,640.38
|
| Rate for Payer: Amida Care Medicaid |
$25,640.38
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$57,690.86
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,640.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,640.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30,768.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,640.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,640.38
|
| Rate for Payer: Healthfirst Commercial |
$27,917.00
|
| Rate for Payer: Healthfirst Essential Plan |
$57,690.86
|
| Rate for Payer: Healthfirst QHP |
$17,534.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,640.38
|
| Rate for Payer: SOMOS Essential |
$57,690.86
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$57,690.86
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$57,690.86
|
| Rate for Payer: United Healthcare Medicaid |
$25,640.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,640.38
|
|
|
Major pancreas, liver & shunt procedures
|
Facility
|
IP
|
$162,629.95
|
|
|
Service Code
|
APR-DRG 2604
|
| Min. Negotiated Rate |
$72,279.98 |
| Max. Negotiated Rate |
$162,629.95 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$162,629.95
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$162,629.95
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$72,279.98
|
| Rate for Payer: Amida Care Medicaid |
$72,279.98
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$162,629.95
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$72,279.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72,279.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$86,735.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$72,279.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$72,279.98
|
| Rate for Payer: Healthfirst Commercial |
$135,978.00
|
| Rate for Payer: Healthfirst Essential Plan |
$162,629.95
|
| Rate for Payer: Healthfirst QHP |
$84,239.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$72,279.98
|
| Rate for Payer: SOMOS Essential |
$162,629.95
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$162,629.95
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$162,629.95
|
| Rate for Payer: United Healthcare Medicaid |
$72,279.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$72,279.98
|
|
|
Major pancreas, liver & shunt procedures
|
Facility
|
IP
|
$67,056.16
|
|
|
Service Code
|
APR-DRG 2602
|
| Min. Negotiated Rate |
$23,339.00 |
| Max. Negotiated Rate |
$67,056.16 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$67,056.16
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$67,056.16
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29,802.74
|
| Rate for Payer: Amida Care Medicaid |
$29,802.74
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$67,056.16
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$29,802.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29,802.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35,763.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29,802.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29,802.74
|
| Rate for Payer: Healthfirst Commercial |
$36,354.00
|
| Rate for Payer: Healthfirst Essential Plan |
$67,056.16
|
| Rate for Payer: Healthfirst QHP |
$23,339.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29,802.74
|
| Rate for Payer: SOMOS Essential |
$67,056.16
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$67,056.16
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$67,056.16
|
| Rate for Payer: United Healthcare Medicaid |
$29,802.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29,802.74
|
|
|
Major respiratory & chest procedures
|
Facility
|
IP
|
$91,186.18
|
|
|
Service Code
|
APR-DRG 1203
|
| Min. Negotiated Rate |
$38,553.00 |
| Max. Negotiated Rate |
$91,186.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$91,186.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$91,186.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$40,527.19
|
| Rate for Payer: Amida Care Medicaid |
$40,527.19
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$91,186.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$40,527.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40,527.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48,632.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40,527.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40,527.19
|
| Rate for Payer: Healthfirst Commercial |
$62,073.00
|
| Rate for Payer: Healthfirst Essential Plan |
$91,186.18
|
| Rate for Payer: Healthfirst QHP |
$38,553.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40,527.19
|
| Rate for Payer: SOMOS Essential |
$91,186.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$91,186.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$91,186.18
|
| Rate for Payer: United Healthcare Medicaid |
$40,527.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40,527.19
|
|
|
Major respiratory & chest procedures
|
Facility
|
IP
|
$69,145.56
|
|
|
Service Code
|
APR-DRG 1202
|
| Min. Negotiated Rate |
$25,039.00 |
| Max. Negotiated Rate |
$69,145.56 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$69,145.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$69,145.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$30,731.36
|
| Rate for Payer: Amida Care Medicaid |
$30,731.36
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$69,145.56
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$30,731.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,731.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36,877.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30,731.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30,731.36
|
| Rate for Payer: Healthfirst Commercial |
$39,946.00
|
| Rate for Payer: Healthfirst Essential Plan |
$69,145.56
|
| Rate for Payer: Healthfirst QHP |
$25,039.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30,731.36
|
| Rate for Payer: SOMOS Essential |
$69,145.56
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$69,145.56
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$69,145.56
|
| Rate for Payer: United Healthcare Medicaid |
$30,731.36
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,731.36
|
|
|
Major respiratory & chest procedures
|
Facility
|
IP
|
$139,138.38
|
|
|
Service Code
|
APR-DRG 1204
|
| Min. Negotiated Rate |
$61,839.28 |
| Max. Negotiated Rate |
$139,138.38 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$139,138.38
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$139,138.38
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$61,839.28
|
| Rate for Payer: Amida Care Medicaid |
$61,839.28
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$139,138.38
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$61,839.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$61,839.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$74,207.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61,839.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$61,839.28
|
| Rate for Payer: Healthfirst Commercial |
$115,850.00
|
| Rate for Payer: Healthfirst Essential Plan |
$139,138.38
|
| Rate for Payer: Healthfirst QHP |
$73,707.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$61,839.28
|
| Rate for Payer: SOMOS Essential |
$139,138.38
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$139,138.38
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$139,138.38
|
| Rate for Payer: United Healthcare Medicaid |
$61,839.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$61,839.28
|
|
|
Major respiratory & chest procedures
|
Facility
|
IP
|
$62,490.46
|
|
|
Service Code
|
APR-DRG 1201
|
| Min. Negotiated Rate |
$19,967.00 |
| Max. Negotiated Rate |
$62,490.46 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$62,490.46
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$62,490.46
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27,773.54
|
| Rate for Payer: Amida Care Medicaid |
$27,773.54
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$62,490.46
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$27,773.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27,773.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33,328.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27,773.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27,773.54
|
| Rate for Payer: Healthfirst Commercial |
$31,420.00
|
| Rate for Payer: Healthfirst Essential Plan |
$62,490.46
|
| Rate for Payer: Healthfirst QHP |
$19,967.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27,773.54
|
| Rate for Payer: SOMOS Essential |
$62,490.46
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$62,490.46
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$62,490.46
|
| Rate for Payer: United Healthcare Medicaid |
$27,773.54
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$27,773.54
|
|
|
Major respiratory infections & inflammations
|
Facility
|
IP
|
$77,956.88
|
|
|
Service Code
|
APR-DRG 1374
|
| Min. Negotiated Rate |
$25,551.00 |
| Max. Negotiated Rate |
$77,956.88 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$77,956.88
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$77,956.88
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,647.50
|
| Rate for Payer: Amida Care Medicaid |
$34,647.50
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$77,956.88
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,647.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,647.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,577.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,647.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,647.50
|
| Rate for Payer: Healthfirst Commercial |
$41,251.00
|
| Rate for Payer: Healthfirst Essential Plan |
$77,956.88
|
| Rate for Payer: Healthfirst QHP |
$25,551.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,647.50
|
| Rate for Payer: SOMOS Essential |
$77,956.88
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$77,956.88
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$77,956.88
|
| Rate for Payer: United Healthcare Medicaid |
$34,647.50
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,647.50
|
|
|
Major respiratory infections & inflammations
|
Facility
|
IP
|
$44,254.04
|
|
|
Service Code
|
APR-DRG 1371
|
| Min. Negotiated Rate |
$11,030.00 |
| Max. Negotiated Rate |
$44,254.04 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,254.04
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,254.04
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,668.46
|
| Rate for Payer: Amida Care Medicaid |
$19,668.46
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,254.04
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,668.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,668.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,602.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,668.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,668.46
|
| Rate for Payer: Healthfirst Commercial |
$16,084.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,254.04
|
| Rate for Payer: Healthfirst QHP |
$11,030.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,668.46
|
| Rate for Payer: SOMOS Essential |
$44,254.04
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,254.04
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,254.04
|
| Rate for Payer: United Healthcare Medicaid |
$19,668.46
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,668.46
|
|
|
Major respiratory infections & inflammations
|
Facility
|
IP
|
$50,145.82
|
|
|
Service Code
|
APR-DRG 1372
|
| Min. Negotiated Rate |
$11,489.00 |
| Max. Negotiated Rate |
$50,145.82 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$50,145.82
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$50,145.82
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,287.03
|
| Rate for Payer: Amida Care Medicaid |
$22,287.03
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$50,145.82
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,287.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,287.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26,744.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,287.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,287.03
|
| Rate for Payer: Healthfirst Commercial |
$18,948.00
|
| Rate for Payer: Healthfirst Essential Plan |
$50,145.82
|
| Rate for Payer: Healthfirst QHP |
$11,489.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,287.03
|
| Rate for Payer: SOMOS Essential |
$50,145.82
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$50,145.82
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$50,145.82
|
| Rate for Payer: United Healthcare Medicaid |
$22,287.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,287.03
|
|
|
Major respiratory infections & inflammations
|
Facility
|
IP
|
$61,507.33
|
|
|
Service Code
|
APR-DRG 1373
|
| Min. Negotiated Rate |
$16,299.00 |
| Max. Negotiated Rate |
$61,507.33 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$61,507.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$61,507.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27,336.59
|
| Rate for Payer: Amida Care Medicaid |
$27,336.59
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$61,507.33
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$27,336.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27,336.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32,803.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27,336.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27,336.59
|
| Rate for Payer: Healthfirst Commercial |
$26,686.00
|
| Rate for Payer: Healthfirst Essential Plan |
$61,507.33
|
| Rate for Payer: Healthfirst QHP |
$16,299.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27,336.59
|
| Rate for Payer: SOMOS Essential |
$61,507.33
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$61,507.33
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$61,507.33
|
| Rate for Payer: United Healthcare Medicaid |
$27,336.59
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$27,336.59
|
|
|
MAJOR SIGNS, SYMPTOMS AND FINDINGS
|
Facility
|
OP
|
$258.32
|
|
|
Service Code
|
EAPG 00510
|
| Min. Negotiated Rate |
$187.46 |
| Max. Negotiated Rate |
$258.32 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$187.46
|
| Rate for Payer: Healthfirst Commercial |
$258.32
|
|
|
MAJOR SKIN DIAGNOSES
|
Facility
|
OP
|
$209.41
|
|
|
Service Code
|
EAPG 00671
|
| Min. Negotiated Rate |
$152.74 |
| Max. Negotiated Rate |
$209.41 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$152.74
|
| Rate for Payer: Healthfirst Commercial |
$209.41
|
|
|
Major skin disorders
|
Facility
|
IP
|
$135,831.94
|
|
|
Service Code
|
APR-DRG 3814
|
| Min. Negotiated Rate |
$36,987.00 |
| Max. Negotiated Rate |
$135,831.94 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$135,831.94
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$135,831.94
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$60,369.75
|
| Rate for Payer: Amida Care Medicaid |
$60,369.75
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$135,831.94
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$60,369.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$60,369.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72,443.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60,369.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60,369.75
|
| Rate for Payer: Healthfirst Commercial |
$64,683.00
|
| Rate for Payer: Healthfirst Essential Plan |
$135,831.94
|
| Rate for Payer: Healthfirst QHP |
$36,987.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$60,369.75
|
| Rate for Payer: SOMOS Essential |
$135,831.94
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$135,831.94
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$135,831.94
|
| Rate for Payer: United Healthcare Medicaid |
$60,369.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$60,369.75
|
|
