St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Cardiac arrest and shock

Facility

$43,131.94

Service Code	APR-DRG 1962
Min. Negotiated Rate	$6,596.00
Max. Negotiated Rate	$43,131.94
Rate for Payer: Affinity Essential Plan 1&2	$43,131.94
Rate for Payer: Affinity Essential Plan 3&4	$43,131.94
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,169.75
Rate for Payer: Amida Care Medicaid	$19,169.75
Rate for Payer: EmblemHealth Essential Plan 1&2	$43,131.94
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,169.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,169.75
Rate for Payer: Fidelis Qualified Health Plan	$23,003.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,169.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,169.75
Rate for Payer: Healthfirst Commercial	$11,482.00
Rate for Payer: Healthfirst Essential Plan	$43,131.94
Rate for Payer: Healthfirst QHP	$6,596.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,169.75
Rate for Payer: SOMOS Essential	$43,131.94
Rate for Payer: United Healthcare Essential Plan 1&2	$43,131.94
Rate for Payer: United Healthcare Essential Plan 3&4	$43,131.94
Rate for Payer: United Healthcare Medicaid	$19,169.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,169.75

Cardiac arrest and shock

Facility

$42,317.64

Service Code	APR-DRG 1961
Min. Negotiated Rate	$5,073.00
Max. Negotiated Rate	$42,317.64
Rate for Payer: Affinity Essential Plan 1&2	$42,317.64
Rate for Payer: Affinity Essential Plan 3&4	$42,317.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,807.84
Rate for Payer: Amida Care Medicaid	$18,807.84
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,317.64
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,807.84
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,807.84
Rate for Payer: Fidelis Qualified Health Plan	$22,569.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,807.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,807.84
Rate for Payer: Healthfirst Commercial	$8,280.00
Rate for Payer: Healthfirst Essential Plan	$42,317.64
Rate for Payer: Healthfirst QHP	$5,073.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,807.84
Rate for Payer: SOMOS Essential	$42,317.64
Rate for Payer: United Healthcare Essential Plan 1&2	$42,317.64
Rate for Payer: United Healthcare Essential Plan 3&4	$42,317.64
Rate for Payer: United Healthcare Medicaid	$18,807.84
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,807.84

Cardiac arrest and shock

Facility

$44,354.27

Service Code	APR-DRG 1963
Min. Negotiated Rate	$8,755.00
Max. Negotiated Rate	$44,354.27
Rate for Payer: Affinity Essential Plan 1&2	$44,354.27
Rate for Payer: Affinity Essential Plan 3&4	$44,354.27
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,713.01
Rate for Payer: Amida Care Medicaid	$19,713.01
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,354.27
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,713.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,713.01
Rate for Payer: Fidelis Qualified Health Plan	$23,655.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,713.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,713.01
Rate for Payer: Healthfirst Commercial	$14,231.00
Rate for Payer: Healthfirst Essential Plan	$44,354.27
Rate for Payer: Healthfirst QHP	$8,755.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,713.01
Rate for Payer: SOMOS Essential	$44,354.27
Rate for Payer: United Healthcare Essential Plan 1&2	$44,354.27
Rate for Payer: United Healthcare Essential Plan 3&4	$44,354.27
Rate for Payer: United Healthcare Medicaid	$19,713.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,713.01

Cardiac arrest and shock

Facility

$68,788.53

Service Code	APR-DRG 1964
Min. Negotiated Rate	$20,119.00
Max. Negotiated Rate	$68,788.53
Rate for Payer: Affinity Essential Plan 1&2	$68,788.53
Rate for Payer: Affinity Essential Plan 3&4	$68,788.53
Rate for Payer: Affinity Medicaid/CHP/HARP	$30,572.68
Rate for Payer: Amida Care Medicaid	$30,572.68
Rate for Payer: EmblemHealth Essential Plan 1&2	$68,788.53
Rate for Payer: EmblemHealth Essential Plan 3&4	$30,572.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,572.68
Rate for Payer: Fidelis Qualified Health Plan	$36,687.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,572.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,572.68
Rate for Payer: Healthfirst Commercial	$31,618.00
Rate for Payer: Healthfirst Essential Plan	$68,788.53
Rate for Payer: Healthfirst QHP	$20,119.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,572.68
Rate for Payer: SOMOS Essential	$68,788.53
Rate for Payer: United Healthcare Essential Plan 1&2	$68,788.53
Rate for Payer: United Healthcare Essential Plan 3&4	$68,788.53
Rate for Payer: United Healthcare Medicaid	$30,572.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,572.68

CARDIAC ARREST OR OTHER CAUSES OF MORTALITY

Facility

$519.63

Service Code	EAPG 00595
Min. Negotiated Rate	$377.23
Max. Negotiated Rate	$519.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$377.23
Rate for Payer: Healthfirst Commercial	$519.63

CARDIAC ARRHYTHMIA AND CONDUCTION DIAGNOSES

Facility

$247.37

Service Code	EAPG 00601
Min. Negotiated Rate	$180.52
Max. Negotiated Rate	$247.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$180.52
Rate for Payer: Healthfirst Commercial	$247.37

Cardiac arrhythmia & conduction disorders

Facility

$76,688.82

Service Code	APR-DRG 2014
Min. Negotiated Rate	$20,957.00
Max. Negotiated Rate	$76,688.82
Rate for Payer: Affinity Essential Plan 1&2	$76,688.82
Rate for Payer: Affinity Essential Plan 3&4	$76,688.82
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,083.92
Rate for Payer: Amida Care Medicaid	$34,083.92
Rate for Payer: EmblemHealth Essential Plan 1&2	$76,688.82
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,083.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,083.92
Rate for Payer: Fidelis Qualified Health Plan	$40,900.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,083.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,083.92
Rate for Payer: Healthfirst Commercial	$43,420.00
Rate for Payer: Healthfirst Essential Plan	$76,688.82
Rate for Payer: Healthfirst QHP	$20,957.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,083.92
Rate for Payer: SOMOS Essential	$76,688.82
Rate for Payer: United Healthcare Essential Plan 1&2	$76,688.82
Rate for Payer: United Healthcare Essential Plan 3&4	$76,688.82
Rate for Payer: United Healthcare Medicaid	$34,083.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,083.92

Cardiac arrhythmia & conduction disorders

Facility

$43,003.55

Service Code	APR-DRG 2012
Min. Negotiated Rate	$7,085.00
Max. Negotiated Rate	$43,003.55
Rate for Payer: Affinity Essential Plan 1&2	$43,003.55
Rate for Payer: Affinity Essential Plan 3&4	$43,003.55
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,112.69
Rate for Payer: Amida Care Medicaid	$19,112.69
Rate for Payer: EmblemHealth Essential Plan 1&2	$43,003.55
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,112.69
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,112.69
Rate for Payer: Fidelis Qualified Health Plan	$22,935.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,112.69
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,112.69
Rate for Payer: Healthfirst Commercial	$12,809.00
Rate for Payer: Healthfirst Essential Plan	$43,003.55
Rate for Payer: Healthfirst QHP	$7,085.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,112.69
Rate for Payer: SOMOS Essential	$43,003.55
Rate for Payer: United Healthcare Essential Plan 1&2	$43,003.55
Rate for Payer: United Healthcare Essential Plan 3&4	$43,003.55
Rate for Payer: United Healthcare Medicaid	$19,112.69
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,112.69

Cardiac arrhythmia & conduction disorders

Facility

$51,097.30

Service Code	APR-DRG 2013
Min. Negotiated Rate	$10,578.00
Max. Negotiated Rate	$51,097.30
Rate for Payer: Affinity Essential Plan 1&2	$51,097.30
Rate for Payer: Affinity Essential Plan 3&4	$51,097.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,709.91
Rate for Payer: Amida Care Medicaid	$22,709.91
Rate for Payer: EmblemHealth Essential Plan 1&2	$51,097.30
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,709.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,709.91
Rate for Payer: Fidelis Qualified Health Plan	$27,251.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,709.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,709.91
Rate for Payer: Healthfirst Commercial	$20,343.00
Rate for Payer: Healthfirst Essential Plan	$51,097.30
Rate for Payer: Healthfirst QHP	$10,578.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,709.91
Rate for Payer: SOMOS Essential	$51,097.30
Rate for Payer: United Healthcare Essential Plan 1&2	$51,097.30
Rate for Payer: United Healthcare Essential Plan 3&4	$51,097.30
Rate for Payer: United Healthcare Medicaid	$22,709.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,709.91

Cardiac arrhythmia & conduction disorders

Facility

$39,623.24

Service Code	APR-DRG 2011
Min. Negotiated Rate	$5,453.00
Max. Negotiated Rate	$39,623.24
Rate for Payer: Affinity Essential Plan 1&2	$39,623.24
Rate for Payer: Affinity Essential Plan 3&4	$39,623.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,610.33
Rate for Payer: Amida Care Medicaid	$17,610.33
Rate for Payer: EmblemHealth Essential Plan 1&2	$39,623.24
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,610.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,610.33
Rate for Payer: Fidelis Qualified Health Plan	$21,132.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,610.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,610.33
Rate for Payer: Healthfirst Commercial	$9,341.00
Rate for Payer: Healthfirst Essential Plan	$39,623.24
Rate for Payer: Healthfirst QHP	$5,453.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,610.33
Rate for Payer: SOMOS Essential	$39,623.24
Rate for Payer: United Healthcare Essential Plan 1&2	$39,623.24
Rate for Payer: United Healthcare Essential Plan 3&4	$39,623.24
Rate for Payer: United Healthcare Medicaid	$17,610.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,610.33

Cardiac catheterization for coronary artery disease

Facility

$44,626.88

Service Code	APR-DRG 1911
Min. Negotiated Rate	$9,497.00
Max. Negotiated Rate	$44,626.88
Rate for Payer: Affinity Essential Plan 1&2	$44,626.88
Rate for Payer: Affinity Essential Plan 3&4	$44,626.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,834.17
Rate for Payer: Amida Care Medicaid	$19,834.17
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,626.88
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,834.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,834.17
Rate for Payer: Fidelis Qualified Health Plan	$23,801.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,834.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,834.17
Rate for Payer: Healthfirst Commercial	$16,705.00
Rate for Payer: Healthfirst Essential Plan	$44,626.88
Rate for Payer: Healthfirst QHP	$9,497.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,834.17
Rate for Payer: SOMOS Essential	$44,626.88
Rate for Payer: United Healthcare Essential Plan 1&2	$44,626.88
Rate for Payer: United Healthcare Essential Plan 3&4	$44,626.88
Rate for Payer: United Healthcare Medicaid	$19,834.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,834.17

Cardiac catheterization for coronary artery disease

Facility

$57,108.69

Service Code	APR-DRG 1913
Min. Negotiated Rate	$15,119.00
Max. Negotiated Rate	$57,108.69
Rate for Payer: Affinity Essential Plan 1&2	$57,108.69
Rate for Payer: Affinity Essential Plan 3&4	$57,108.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$25,381.64
Rate for Payer: Amida Care Medicaid	$25,381.64
Rate for Payer: EmblemHealth Essential Plan 1&2	$57,108.69
Rate for Payer: EmblemHealth Essential Plan 3&4	$25,381.64
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,381.64
Rate for Payer: Fidelis Qualified Health Plan	$30,457.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,381.64
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,381.64
Rate for Payer: Healthfirst Commercial	$28,946.00
Rate for Payer: Healthfirst Essential Plan	$57,108.69
Rate for Payer: Healthfirst QHP	$15,119.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,381.64
Rate for Payer: SOMOS Essential	$57,108.69
Rate for Payer: United Healthcare Essential Plan 1&2	$57,108.69
Rate for Payer: United Healthcare Essential Plan 3&4	$57,108.69
Rate for Payer: United Healthcare Medicaid	$25,381.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,381.64

Cardiac catheterization for coronary artery disease

Facility

$47,426.81

Service Code	APR-DRG 1912
Min. Negotiated Rate	$11,373.00
Max. Negotiated Rate	$47,426.81
Rate for Payer: Affinity Essential Plan 1&2	$47,426.81
Rate for Payer: Affinity Essential Plan 3&4	$47,426.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,078.58
Rate for Payer: Amida Care Medicaid	$21,078.58
Rate for Payer: EmblemHealth Essential Plan 1&2	$47,426.81
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,078.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,078.58
Rate for Payer: Fidelis Qualified Health Plan	$25,294.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,078.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,078.58
Rate for Payer: Healthfirst Commercial	$20,456.00
Rate for Payer: Healthfirst Essential Plan	$47,426.81
Rate for Payer: Healthfirst QHP	$11,373.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,078.58
Rate for Payer: SOMOS Essential	$47,426.81
Rate for Payer: United Healthcare Essential Plan 1&2	$47,426.81
Rate for Payer: United Healthcare Essential Plan 3&4	$47,426.81
Rate for Payer: United Healthcare Medicaid	$21,078.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,078.58

Cardiac catheterization for coronary artery disease

Facility

$80,242.00

Service Code	APR-DRG 1914
Min. Negotiated Rate	$33,900.00
Max. Negotiated Rate	$80,242.00
Rate for Payer: Affinity Essential Plan 1&2	$78,579.47
Rate for Payer: Affinity Essential Plan 3&4	$78,579.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,924.21
Rate for Payer: Amida Care Medicaid	$34,924.21
Rate for Payer: EmblemHealth Essential Plan 1&2	$78,579.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,924.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,924.21
Rate for Payer: Fidelis Qualified Health Plan	$41,909.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,924.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,924.21
Rate for Payer: Healthfirst Commercial	$80,242.00
Rate for Payer: Healthfirst Essential Plan	$78,579.47
Rate for Payer: Healthfirst QHP	$33,900.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,924.21
Rate for Payer: SOMOS Essential	$78,579.47
Rate for Payer: United Healthcare Essential Plan 1&2	$78,579.47
Rate for Payer: United Healthcare Essential Plan 3&4	$78,579.47
Rate for Payer: United Healthcare Medicaid	$34,924.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,924.21

Cardiac catheterization for other non-coronary conditions

Facility

$49,945.32

Service Code	APR-DRG 1922
Min. Negotiated Rate	$8,834.00
Max. Negotiated Rate	$49,945.32
Rate for Payer: Affinity Essential Plan 1&2	$49,945.32
Rate for Payer: Affinity Essential Plan 3&4	$49,945.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,197.92
Rate for Payer: Amida Care Medicaid	$22,197.92
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,945.32
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,197.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,197.92
Rate for Payer: Fidelis Qualified Health Plan	$26,637.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,197.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,197.92
Rate for Payer: Healthfirst Commercial	$16,183.00
Rate for Payer: Healthfirst Essential Plan	$49,945.32
Rate for Payer: Healthfirst QHP	$8,834.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,197.92
Rate for Payer: SOMOS Essential	$49,945.32
Rate for Payer: United Healthcare Essential Plan 1&2	$49,945.32
Rate for Payer: United Healthcare Essential Plan 3&4	$49,945.32
Rate for Payer: United Healthcare Medicaid	$22,197.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,197.92

Cardiac catheterization for other non-coronary conditions

Facility

$64,024.09

Service Code	APR-DRG 1923
Min. Negotiated Rate	$12,172.00
Max. Negotiated Rate	$64,024.09
Rate for Payer: Affinity Essential Plan 1&2	$64,024.09
Rate for Payer: Affinity Essential Plan 3&4	$64,024.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,455.15
Rate for Payer: Amida Care Medicaid	$28,455.15
Rate for Payer: EmblemHealth Essential Plan 1&2	$64,024.09
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,455.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,455.15
Rate for Payer: Fidelis Qualified Health Plan	$34,146.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,455.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,455.15
Rate for Payer: Healthfirst Commercial	$22,228.00
Rate for Payer: Healthfirst Essential Plan	$64,024.09
Rate for Payer: Healthfirst QHP	$12,172.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,455.15
Rate for Payer: SOMOS Essential	$64,024.09
Rate for Payer: United Healthcare Essential Plan 1&2	$64,024.09
Rate for Payer: United Healthcare Essential Plan 3&4	$64,024.09
Rate for Payer: United Healthcare Medicaid	$28,455.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,455.15

Cardiac catheterization for other non-coronary conditions

Facility

$44,646.23

Service Code	APR-DRG 1921
Min. Negotiated Rate	$7,646.00
Max. Negotiated Rate	$44,646.23
Rate for Payer: Affinity Essential Plan 1&2	$44,646.23
Rate for Payer: Affinity Essential Plan 3&4	$44,646.23
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,842.77
Rate for Payer: Amida Care Medicaid	$19,842.77
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,646.23
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,842.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,842.77
Rate for Payer: Fidelis Qualified Health Plan	$23,811.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,842.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,842.77
Rate for Payer: Healthfirst Commercial	$13,491.00
Rate for Payer: Healthfirst Essential Plan	$44,646.23
Rate for Payer: Healthfirst QHP	$7,646.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,842.77
Rate for Payer: SOMOS Essential	$44,646.23
Rate for Payer: United Healthcare Essential Plan 1&2	$44,646.23
Rate for Payer: United Healthcare Essential Plan 3&4	$44,646.23
Rate for Payer: United Healthcare Medicaid	$19,842.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,842.77

Cardiac catheterization for other non-coronary conditions

Facility

$104,429.52

Service Code	APR-DRG 1924
Min. Negotiated Rate	$21,665.00
Max. Negotiated Rate	$104,429.52
Rate for Payer: Affinity Essential Plan 1&2	$104,429.52
Rate for Payer: Affinity Essential Plan 3&4	$104,429.52
Rate for Payer: Affinity Medicaid/CHP/HARP	$46,413.12
Rate for Payer: Amida Care Medicaid	$46,413.12
Rate for Payer: EmblemHealth Essential Plan 1&2	$104,429.52
Rate for Payer: EmblemHealth Essential Plan 3&4	$46,413.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$46,413.12
Rate for Payer: Fidelis Qualified Health Plan	$55,695.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$46,413.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$46,413.12
Rate for Payer: Healthfirst Commercial	$58,081.00
Rate for Payer: Healthfirst Essential Plan	$104,429.52
Rate for Payer: Healthfirst QHP	$21,665.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$46,413.12
Rate for Payer: SOMOS Essential	$104,429.52
Rate for Payer: United Healthcare Essential Plan 1&2	$104,429.52
Rate for Payer: United Healthcare Essential Plan 3&4	$104,429.52
Rate for Payer: United Healthcare Medicaid	$46,413.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$46,413.12

Cardiac defibrillator & heart assist implant

Facility

$102,618.02

Service Code	APR-DRG 1611
Min. Negotiated Rate	$45,608.01
Max. Negotiated Rate	$102,618.02
Rate for Payer: Affinity Essential Plan 1&2	$102,618.02
Rate for Payer: Affinity Essential Plan 3&4	$102,618.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$45,608.01
Rate for Payer: Amida Care Medicaid	$45,608.01
Rate for Payer: EmblemHealth Essential Plan 1&2	$102,618.02
Rate for Payer: EmblemHealth Essential Plan 3&4	$45,608.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45,608.01
Rate for Payer: Fidelis Qualified Health Plan	$54,729.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$45,608.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$45,608.01
Rate for Payer: Healthfirst Commercial	$77,958.00
Rate for Payer: Healthfirst Essential Plan	$102,618.02
Rate for Payer: Healthfirst QHP	$54,302.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45,608.01
Rate for Payer: SOMOS Essential	$102,618.02
Rate for Payer: United Healthcare Essential Plan 1&2	$102,618.02
Rate for Payer: United Healthcare Essential Plan 3&4	$102,618.02
Rate for Payer: United Healthcare Medicaid	$45,608.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45,608.01

Cardiac defibrillator & heart assist implant

Facility

$139,785.59

Service Code	APR-DRG 1612
Min. Negotiated Rate	$62,126.93
Max. Negotiated Rate	$139,785.59
Rate for Payer: Affinity Essential Plan 1&2	$139,785.59
Rate for Payer: Affinity Essential Plan 3&4	$139,785.59
Rate for Payer: Affinity Medicaid/CHP/HARP	$62,126.93
Rate for Payer: Amida Care Medicaid	$62,126.93
Rate for Payer: EmblemHealth Essential Plan 1&2	$139,785.59
Rate for Payer: EmblemHealth Essential Plan 3&4	$62,126.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$62,126.93
Rate for Payer: Fidelis Qualified Health Plan	$74,552.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$62,126.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62,126.93
Rate for Payer: Healthfirst Commercial	$114,661.00
Rate for Payer: Healthfirst Essential Plan	$139,785.59
Rate for Payer: Healthfirst QHP	$72,175.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62,126.93
Rate for Payer: SOMOS Essential	$139,785.59
Rate for Payer: United Healthcare Essential Plan 1&2	$139,785.59
Rate for Payer: United Healthcare Essential Plan 3&4	$139,785.59
Rate for Payer: United Healthcare Medicaid	$62,126.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$62,126.93

Cardiac defibrillator & heart assist implant

Facility

$205,070.27

Service Code	APR-DRG 1613
Min. Negotiated Rate	$91,142.34
Max. Negotiated Rate	$205,070.27
Rate for Payer: Affinity Essential Plan 1&2	$205,070.27
Rate for Payer: Affinity Essential Plan 3&4	$205,070.27
Rate for Payer: Affinity Medicaid/CHP/HARP	$91,142.34
Rate for Payer: Amida Care Medicaid	$91,142.34
Rate for Payer: EmblemHealth Essential Plan 1&2	$205,070.27
Rate for Payer: EmblemHealth Essential Plan 3&4	$91,142.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$91,142.34
Rate for Payer: Fidelis Qualified Health Plan	$109,370.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$91,142.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$91,142.34
Rate for Payer: Healthfirst Commercial	$192,154.00
Rate for Payer: Healthfirst Essential Plan	$205,070.27
Rate for Payer: Healthfirst QHP	$112,207.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$91,142.34
Rate for Payer: SOMOS Essential	$205,070.27
Rate for Payer: United Healthcare Essential Plan 1&2	$205,070.27
Rate for Payer: United Healthcare Essential Plan 3&4	$205,070.27
Rate for Payer: United Healthcare Medicaid	$91,142.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$91,142.34

Cardiac defibrillator & heart assist implant

Facility

$437,949.38

Service Code	APR-DRG 1614
Min. Negotiated Rate	$194,644.17
Max. Negotiated Rate	$437,949.38
Rate for Payer: Affinity Essential Plan 1&2	$437,949.38
Rate for Payer: Affinity Essential Plan 3&4	$437,949.38
Rate for Payer: Affinity Medicaid/CHP/HARP	$194,644.17
Rate for Payer: Amida Care Medicaid	$194,644.17
Rate for Payer: EmblemHealth Essential Plan 1&2	$437,949.38
Rate for Payer: EmblemHealth Essential Plan 3&4	$194,644.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$194,644.17
Rate for Payer: Fidelis Qualified Health Plan	$233,573.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$194,644.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$194,644.17
Rate for Payer: Healthfirst Commercial	$398,439.00
Rate for Payer: Healthfirst Essential Plan	$437,949.38
Rate for Payer: Healthfirst QHP	$277,689.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$194,644.17
Rate for Payer: SOMOS Essential	$437,949.38
Rate for Payer: United Healthcare Essential Plan 1&2	$437,949.38
Rate for Payer: United Healthcare Essential Plan 3&4	$437,949.38
Rate for Payer: United Healthcare Medicaid	$194,644.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$194,644.17

CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING

Facility

$1,603.50

Service Code	EAPG 00082
Min. Negotiated Rate	$1,164.09
Max. Negotiated Rate	$1,603.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,164.09
Rate for Payer: Healthfirst Commercial	$1,603.50

Cardiac pacemaker & defibrillator device replacement

Facility

$78,454.60

Service Code	APR-DRG 1762
Min. Negotiated Rate	$34,868.71
Max. Negotiated Rate	$78,454.60
Rate for Payer: Affinity Essential Plan 1&2	$78,454.60
Rate for Payer: Affinity Essential Plan 3&4	$78,454.60
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,868.71
Rate for Payer: Amida Care Medicaid	$34,868.71
Rate for Payer: EmblemHealth Essential Plan 1&2	$78,454.60
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,868.71
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,868.71
Rate for Payer: Fidelis Qualified Health Plan	$41,842.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,868.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,868.71
Rate for Payer: Healthfirst Commercial	$47,587.00
Rate for Payer: Healthfirst Essential Plan	$78,454.60
Rate for Payer: Healthfirst QHP	$43,368.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,868.71
Rate for Payer: SOMOS Essential	$78,454.60
Rate for Payer: United Healthcare Essential Plan 1&2	$78,454.60
Rate for Payer: United Healthcare Essential Plan 3&4	$78,454.60
Rate for Payer: United Healthcare Medicaid	$34,868.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,868.71

Cardiac pacemaker & defibrillator device replacement

Facility

$91,191.44

Service Code	APR-DRG 1763
Min. Negotiated Rate	$40,529.53
Max. Negotiated Rate	$91,191.44
Rate for Payer: Affinity Essential Plan 1&2	$91,191.44
Rate for Payer: Affinity Essential Plan 3&4	$91,191.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$40,529.53
Rate for Payer: Amida Care Medicaid	$40,529.53
Rate for Payer: EmblemHealth Essential Plan 1&2	$91,191.44
Rate for Payer: EmblemHealth Essential Plan 3&4	$40,529.53
Rate for Payer: Fidelis CHP/HARP/Medicaid	$40,529.53
Rate for Payer: Fidelis Qualified Health Plan	$48,635.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$40,529.53
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40,529.53
Rate for Payer: Healthfirst Commercial	$52,768.00
Rate for Payer: Healthfirst Essential Plan	$91,191.44
Rate for Payer: Healthfirst QHP	$42,968.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40,529.53
Rate for Payer: SOMOS Essential	$91,191.44
Rate for Payer: United Healthcare Essential Plan 1&2	$91,191.44
Rate for Payer: United Healthcare Essential Plan 3&4	$91,191.44
Rate for Payer: United Healthcare Medicaid	$40,529.53
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40,529.53

Know your out-of-pocket cost for care.

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