|
Major skin disorders
|
Facility
|
IP
|
$65,909.48
|
|
|
Service Code
|
APR-DRG 3813
|
| Min. Negotiated Rate |
$13,513.00 |
| Max. Negotiated Rate |
$65,909.48 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$65,909.48
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$65,909.48
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$29,293.10
|
| Rate for Payer: Amida Care Medicaid |
$29,293.10
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$65,909.48
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$29,293.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29,293.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35,151.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29,293.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29,293.10
|
| Rate for Payer: Healthfirst Commercial |
$24,218.00
|
| Rate for Payer: Healthfirst Essential Plan |
$65,909.48
|
| Rate for Payer: Healthfirst QHP |
$13,513.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29,293.10
|
| Rate for Payer: SOMOS Essential |
$65,909.48
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$65,909.48
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$65,909.48
|
| Rate for Payer: United Healthcare Medicaid |
$29,293.10
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$29,293.10
|
|
|
Major skin disorders
|
Facility
|
IP
|
$42,472.42
|
|
|
Service Code
|
APR-DRG 3811
|
| Min. Negotiated Rate |
$6,248.00 |
| Max. Negotiated Rate |
$42,472.42 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$42,472.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$42,472.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,876.63
|
| Rate for Payer: Amida Care Medicaid |
$18,876.63
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$42,472.42
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,876.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,876.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,651.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,876.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,876.63
|
| Rate for Payer: Healthfirst Commercial |
$11,158.00
|
| Rate for Payer: Healthfirst Essential Plan |
$42,472.42
|
| Rate for Payer: Healthfirst QHP |
$6,248.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,876.63
|
| Rate for Payer: SOMOS Essential |
$42,472.42
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$42,472.42
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$42,472.42
|
| Rate for Payer: United Healthcare Medicaid |
$18,876.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,876.63
|
|
|
Major skin disorders
|
Facility
|
IP
|
$47,504.18
|
|
|
Service Code
|
APR-DRG 3812
|
| Min. Negotiated Rate |
$8,811.00 |
| Max. Negotiated Rate |
$47,504.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$47,504.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$47,504.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$21,112.97
|
| Rate for Payer: Amida Care Medicaid |
$21,112.97
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$47,504.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$21,112.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21,112.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25,335.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21,112.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21,112.97
|
| Rate for Payer: Healthfirst Commercial |
$14,857.00
|
| Rate for Payer: Healthfirst Essential Plan |
$47,504.18
|
| Rate for Payer: Healthfirst QHP |
$8,811.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21,112.97
|
| Rate for Payer: SOMOS Essential |
$47,504.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$47,504.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$47,504.18
|
| Rate for Payer: United Healthcare Medicaid |
$21,112.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,112.97
|
|
|
Major small & large bowel procedures
|
Facility
|
IP
|
$86,562.43
|
|
|
Service Code
|
APR-DRG 2213
|
| Min. Negotiated Rate |
$34,086.00 |
| Max. Negotiated Rate |
$86,562.43 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$86,562.43
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$86,562.43
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$38,472.19
|
| Rate for Payer: Amida Care Medicaid |
$38,472.19
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$86,562.43
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$38,472.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38,472.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$46,166.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38,472.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38,472.19
|
| Rate for Payer: Healthfirst Commercial |
$58,175.00
|
| Rate for Payer: Healthfirst Essential Plan |
$86,562.43
|
| Rate for Payer: Healthfirst QHP |
$34,086.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38,472.19
|
| Rate for Payer: SOMOS Essential |
$86,562.43
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$86,562.43
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$86,562.43
|
| Rate for Payer: United Healthcare Medicaid |
$38,472.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$38,472.19
|
|
|
Major small & large bowel procedures
|
Facility
|
IP
|
$65,128.59
|
|
|
Service Code
|
APR-DRG 2212
|
| Min. Negotiated Rate |
$21,173.00 |
| Max. Negotiated Rate |
$65,128.59 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$65,128.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$65,128.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28,946.04
|
| Rate for Payer: Amida Care Medicaid |
$28,946.04
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$65,128.59
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$28,946.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28,946.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34,735.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28,946.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28,946.04
|
| Rate for Payer: Healthfirst Commercial |
$35,123.00
|
| Rate for Payer: Healthfirst Essential Plan |
$65,128.59
|
| Rate for Payer: Healthfirst QHP |
$21,173.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28,946.04
|
| Rate for Payer: SOMOS Essential |
$65,128.59
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$65,128.59
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$65,128.59
|
| Rate for Payer: United Healthcare Medicaid |
$28,946.04
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28,946.04
|
|
|
Major small & large bowel procedures
|
Facility
|
IP
|
$148,239.90
|
|
|
Service Code
|
APR-DRG 2214
|
| Min. Negotiated Rate |
$65,884.40 |
| Max. Negotiated Rate |
$148,239.90 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$148,239.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$148,239.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$65,884.40
|
| Rate for Payer: Amida Care Medicaid |
$65,884.40
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$148,239.90
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$65,884.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$65,884.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$79,061.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$65,884.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$65,884.40
|
| Rate for Payer: Healthfirst Commercial |
$115,187.00
|
| Rate for Payer: Healthfirst Essential Plan |
$148,239.90
|
| Rate for Payer: Healthfirst QHP |
$69,553.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$65,884.40
|
| Rate for Payer: SOMOS Essential |
$148,239.90
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$148,239.90
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$148,239.90
|
| Rate for Payer: United Healthcare Medicaid |
$65,884.40
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$65,884.40
|
|
|
Major small & large bowel procedures
|
Facility
|
IP
|
$58,162.18
|
|
|
Service Code
|
APR-DRG 2211
|
| Min. Negotiated Rate |
$16,712.00 |
| Max. Negotiated Rate |
$58,162.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$58,162.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$58,162.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,849.86
|
| Rate for Payer: Amida Care Medicaid |
$25,849.86
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$58,162.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,849.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,849.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31,019.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,849.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,849.86
|
| Rate for Payer: Healthfirst Commercial |
$27,590.00
|
| Rate for Payer: Healthfirst Essential Plan |
$58,162.18
|
| Rate for Payer: Healthfirst QHP |
$16,712.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,849.86
|
| Rate for Payer: SOMOS Essential |
$58,162.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$58,162.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$58,162.18
|
| Rate for Payer: United Healthcare Medicaid |
$25,849.86
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,849.86
|
|
|
Major stomach, esophageal & duodenal procedures
|
Facility
|
IP
|
$91,863.29
|
|
|
Service Code
|
APR-DRG 2203
|
| Min. Negotiated Rate |
$39,790.00 |
| Max. Negotiated Rate |
$91,863.29 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$91,863.29
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$91,863.29
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$40,828.13
|
| Rate for Payer: Amida Care Medicaid |
$40,828.13
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$91,863.29
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$40,828.13
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40,828.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48,993.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40,828.13
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40,828.13
|
| Rate for Payer: Healthfirst Commercial |
$62,671.00
|
| Rate for Payer: Healthfirst Essential Plan |
$91,863.29
|
| Rate for Payer: Healthfirst QHP |
$39,790.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40,828.13
|
| Rate for Payer: SOMOS Essential |
$91,863.29
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$91,863.29
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$91,863.29
|
| Rate for Payer: United Healthcare Medicaid |
$40,828.13
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40,828.13
|
|
|
Major stomach, esophageal & duodenal procedures
|
Facility
|
IP
|
$64,469.05
|
|
|
Service Code
|
APR-DRG 2202
|
| Min. Negotiated Rate |
$22,319.00 |
| Max. Negotiated Rate |
$64,469.05 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$64,469.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$64,469.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28,652.91
|
| Rate for Payer: Amida Care Medicaid |
$28,652.91
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$64,469.05
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$28,652.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28,652.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34,383.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28,652.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28,652.91
|
| Rate for Payer: Healthfirst Commercial |
$36,320.00
|
| Rate for Payer: Healthfirst Essential Plan |
$64,469.05
|
| Rate for Payer: Healthfirst QHP |
$22,319.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28,652.91
|
| Rate for Payer: SOMOS Essential |
$64,469.05
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$64,469.05
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$64,469.05
|
| Rate for Payer: United Healthcare Medicaid |
$28,652.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28,652.91
|
|
|
Major stomach, esophageal & duodenal procedures
|
Facility
|
IP
|
$52,393.50
|
|
|
Service Code
|
APR-DRG 2201
|
| Min. Negotiated Rate |
$14,682.00 |
| Max. Negotiated Rate |
$52,393.50 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$52,393.50
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$52,393.50
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,286.00
|
| Rate for Payer: Amida Care Medicaid |
$23,286.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$52,393.50
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,286.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,286.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,943.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,286.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,286.00
|
| Rate for Payer: Healthfirst Commercial |
$23,772.00
|
| Rate for Payer: Healthfirst Essential Plan |
$52,393.50
|
| Rate for Payer: Healthfirst QHP |
$14,682.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,286.00
|
| Rate for Payer: SOMOS Essential |
$52,393.50
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$52,393.50
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$52,393.50
|
| Rate for Payer: United Healthcare Medicaid |
$23,286.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,286.00
|
|
|
Major stomach, esophageal & duodenal procedures
|
Facility
|
IP
|
$156,671.33
|
|
|
Service Code
|
APR-DRG 2204
|
| Min. Negotiated Rate |
$69,631.70 |
| Max. Negotiated Rate |
$156,671.33 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$156,671.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$156,671.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$69,631.70
|
| Rate for Payer: Amida Care Medicaid |
$69,631.70
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$156,671.33
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$69,631.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69,631.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83,558.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$69,631.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$69,631.70
|
| Rate for Payer: Healthfirst Commercial |
$132,555.00
|
| Rate for Payer: Healthfirst Essential Plan |
$156,671.33
|
| Rate for Payer: Healthfirst QHP |
$79,821.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69,631.70
|
| Rate for Payer: SOMOS Essential |
$156,671.33
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$156,671.33
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$156,671.33
|
| Rate for Payer: United Healthcare Medicaid |
$69,631.70
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$69,631.70
|
|
|
Male reproductive system diagnoses except malignancy
|
Facility
|
IP
|
$69,523.70
|
|
|
Service Code
|
APR-DRG 5014
|
| Min. Negotiated Rate |
$18,508.00 |
| Max. Negotiated Rate |
$69,523.70 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$69,523.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$69,523.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$30,899.42
|
| Rate for Payer: Amida Care Medicaid |
$30,899.42
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$69,523.70
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$30,899.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30,899.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37,079.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30,899.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30,899.42
|
| Rate for Payer: Healthfirst Commercial |
$38,065.00
|
| Rate for Payer: Healthfirst Essential Plan |
$69,523.70
|
| Rate for Payer: Healthfirst QHP |
$18,508.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30,899.42
|
| Rate for Payer: SOMOS Essential |
$69,523.70
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$69,523.70
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$69,523.70
|
| Rate for Payer: United Healthcare Medicaid |
$30,899.42
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,899.42
|
|
|
Male reproductive system diagnoses except malignancy
|
Facility
|
IP
|
$40,518.45
|
|
|
Service Code
|
APR-DRG 5011
|
| Min. Negotiated Rate |
$5,681.00 |
| Max. Negotiated Rate |
$40,518.45 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,518.45
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,518.45
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,008.20
|
| Rate for Payer: Amida Care Medicaid |
$18,008.20
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,518.45
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,008.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,008.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,609.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,008.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,008.20
|
| Rate for Payer: Healthfirst Commercial |
$9,623.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,518.45
|
| Rate for Payer: Healthfirst QHP |
$5,681.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,008.20
|
| Rate for Payer: SOMOS Essential |
$40,518.45
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,518.45
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,518.45
|
| Rate for Payer: United Healthcare Medicaid |
$18,008.20
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,008.20
|
|
|
Male reproductive system diagnoses except malignancy
|
Facility
|
IP
|
$51,762.11
|
|
|
Service Code
|
APR-DRG 5013
|
| Min. Negotiated Rate |
$10,221.00 |
| Max. Negotiated Rate |
$51,762.11 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,762.11
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,762.11
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,005.38
|
| Rate for Payer: Amida Care Medicaid |
$23,005.38
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,762.11
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,005.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,005.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,606.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,005.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,005.38
|
| Rate for Payer: Healthfirst Commercial |
$18,314.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,762.11
|
| Rate for Payer: Healthfirst QHP |
$10,221.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,005.38
|
| Rate for Payer: SOMOS Essential |
$51,762.11
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,762.11
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,762.11
|
| Rate for Payer: United Healthcare Medicaid |
$23,005.38
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,005.38
|
|
|
Male reproductive system diagnoses except malignancy
|
Facility
|
IP
|
$44,079.91
|
|
|
Service Code
|
APR-DRG 5012
|
| Min. Negotiated Rate |
$7,295.00 |
| Max. Negotiated Rate |
$44,079.91 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,079.91
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,079.91
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,591.07
|
| Rate for Payer: Amida Care Medicaid |
$19,591.07
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,079.91
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,591.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,591.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,509.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,591.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,591.07
|
| Rate for Payer: Healthfirst Commercial |
$12,359.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,079.91
|
| Rate for Payer: Healthfirst QHP |
$7,295.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,591.07
|
| Rate for Payer: SOMOS Essential |
$44,079.91
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,079.91
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,079.91
|
| Rate for Payer: United Healthcare Medicaid |
$19,591.07
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,591.07
|
|
|
MALE REPRODUCTIVE SYSTEM INFECTIONS
|
Facility
|
OP
|
$241.84
|
|
|
Service Code
|
EAPG 00744
|
| Min. Negotiated Rate |
$175.89 |
| Max. Negotiated Rate |
$241.84 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$175.89
|
| Rate for Payer: Healthfirst Commercial |
$241.84
|
|
|
MALE REPRODUCTIVE SYSTEM MALIGNANCY
|
Facility
|
OP
|
$220.82
|
|
|
Service Code
|
EAPG 00740
|
| Min. Negotiated Rate |
$159.69 |
| Max. Negotiated Rate |
$220.82 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$159.69
|
| Rate for Payer: Healthfirst Commercial |
$220.82
|
|
|
MALFUNCTION, REACTION AND COMPLICATION OF GI DEVICE OR PROCEDURE
|
Facility
|
OP
|
$282.14
|
|
|
Service Code
|
EAPG 00629
|
| Min. Negotiated Rate |
$203.66 |
| Max. Negotiated Rate |
$282.14 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$203.66
|
| Rate for Payer: Healthfirst Commercial |
$282.14
|
|
|
Malfunction,reaction,complication of cardiac/vasc device or procedure
|
Facility
|
IP
|
$53,899.00
|
|
|
Service Code
|
APR-DRG 2063
|
| Min. Negotiated Rate |
$13,535.00 |
| Max. Negotiated Rate |
$53,899.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$53,899.00
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$53,899.00
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,955.11
|
| Rate for Payer: Amida Care Medicaid |
$23,955.11
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$53,899.00
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,955.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,955.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,746.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,955.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,955.11
|
| Rate for Payer: Healthfirst Commercial |
$22,856.00
|
| Rate for Payer: Healthfirst Essential Plan |
$53,899.00
|
| Rate for Payer: Healthfirst QHP |
$13,535.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,955.11
|
| Rate for Payer: SOMOS Essential |
$53,899.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$53,899.00
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$53,899.00
|
| Rate for Payer: United Healthcare Medicaid |
$23,955.11
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,955.11
|
|
|
Malfunction,reaction,complication of cardiac/vasc device or procedure
|
Facility
|
IP
|
$41,686.25
|
|
|
Service Code
|
APR-DRG 2061
|
| Min. Negotiated Rate |
$6,645.00 |
| Max. Negotiated Rate |
$41,686.25 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,686.25
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,686.25
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,527.22
|
| Rate for Payer: Amida Care Medicaid |
$18,527.22
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,686.25
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,527.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,527.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,232.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,527.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,527.22
|
| Rate for Payer: Healthfirst Commercial |
$10,119.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,686.25
|
| Rate for Payer: Healthfirst QHP |
$6,645.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,527.22
|
| Rate for Payer: SOMOS Essential |
$41,686.25
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,686.25
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,686.25
|
| Rate for Payer: United Healthcare Medicaid |
$18,527.22
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,527.22
|
|
|
Malfunction,reaction,complication of cardiac/vasc device or procedure
|
Facility
|
IP
|
$44,815.07
|
|
|
Service Code
|
APR-DRG 2062
|
| Min. Negotiated Rate |
$8,271.00 |
| Max. Negotiated Rate |
$44,815.07 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,815.07
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,815.07
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,917.81
|
| Rate for Payer: Amida Care Medicaid |
$19,917.81
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,815.07
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,917.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,917.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,901.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,917.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,917.81
|
| Rate for Payer: Healthfirst Commercial |
$13,727.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,815.07
|
| Rate for Payer: Healthfirst QHP |
$8,271.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,917.81
|
| Rate for Payer: SOMOS Essential |
$44,815.07
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,815.07
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,815.07
|
| Rate for Payer: United Healthcare Medicaid |
$19,917.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,917.81
|
|
|
Malfunction,reaction,complication of cardiac/vasc device or procedure
|
Facility
|
IP
|
$91,893.17
|
|
|
Service Code
|
APR-DRG 2064
|
| Min. Negotiated Rate |
$28,294.00 |
| Max. Negotiated Rate |
$91,893.17 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$91,893.17
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$91,893.17
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$40,841.41
|
| Rate for Payer: Amida Care Medicaid |
$40,841.41
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$91,893.17
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$40,841.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40,841.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49,009.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40,841.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40,841.41
|
| Rate for Payer: Healthfirst Commercial |
$50,746.00
|
| Rate for Payer: Healthfirst Essential Plan |
$91,893.17
|
| Rate for Payer: Healthfirst QHP |
$28,294.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40,841.41
|
| Rate for Payer: SOMOS Essential |
$91,893.17
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$91,893.17
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$91,893.17
|
| Rate for Payer: United Healthcare Medicaid |
$40,841.41
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40,841.41
|
|
|
Malfunction, reaction & complication of GI device or procedure
|
Facility
|
IP
|
$53,860.30
|
|
|
Service Code
|
APR-DRG 2523
|
| Min. Negotiated Rate |
$12,360.00 |
| Max. Negotiated Rate |
$53,860.30 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$53,860.30
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$53,860.30
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,937.91
|
| Rate for Payer: Amida Care Medicaid |
$23,937.91
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$53,860.30
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,937.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,937.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,725.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,937.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,937.91
|
| Rate for Payer: Healthfirst Commercial |
$21,568.00
|
| Rate for Payer: Healthfirst Essential Plan |
$53,860.30
|
| Rate for Payer: Healthfirst QHP |
$12,360.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,937.91
|
| Rate for Payer: SOMOS Essential |
$53,860.30
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$53,860.30
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$53,860.30
|
| Rate for Payer: United Healthcare Medicaid |
$23,937.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,937.91
|
|
|
Malfunction, reaction & complication of GI device or procedure
|
Facility
|
IP
|
$45,748.96
|
|
|
Service Code
|
APR-DRG 2522
|
| Min. Negotiated Rate |
$8,236.00 |
| Max. Negotiated Rate |
$45,748.96 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,748.96
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,748.96
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,332.87
|
| Rate for Payer: Amida Care Medicaid |
$20,332.87
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,748.96
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,332.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,332.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,399.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,332.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,332.87
|
| Rate for Payer: Healthfirst Commercial |
$13,904.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,748.96
|
| Rate for Payer: Healthfirst QHP |
$8,236.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,332.87
|
| Rate for Payer: SOMOS Essential |
$45,748.96
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,748.96
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,748.96
|
| Rate for Payer: United Healthcare Medicaid |
$20,332.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,332.87
|
|
|
Malfunction, reaction & complication of GI device or procedure
|
Facility
|
IP
|
$81,863.05
|
|
|
Service Code
|
APR-DRG 2524
|
| Min. Negotiated Rate |
$24,811.00 |
| Max. Negotiated Rate |
$81,863.05 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$81,863.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$81,863.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$36,383.58
|
| Rate for Payer: Amida Care Medicaid |
$36,383.58
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$81,863.05
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$36,383.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36,383.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$43,660.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36,383.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36,383.58
|
| Rate for Payer: Healthfirst Commercial |
$43,377.00
|
| Rate for Payer: Healthfirst Essential Plan |
$81,863.05
|
| Rate for Payer: Healthfirst QHP |
$24,811.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$36,383.58
|
| Rate for Payer: SOMOS Essential |
$81,863.05
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$81,863.05
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$81,863.05
|
| Rate for Payer: United Healthcare Medicaid |
$36,383.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$36,383.58
|
|
