St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 0032: Bone marrow transplant

Facility IP

$243,114.00

Service Code	APR-DRG 0032
Min. Negotiated Rate	$73,836.61
Max. Negotiated Rate	$243,114.00
Rate for Payer: Amida Care Medicaid	$73,836.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$73,836.61
Rate for Payer: Fidelis Qualified Health Plan	$88,603.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$73,836.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73,836.61
Rate for Payer: Healthfirst Commercial	$243,114.00
Rate for Payer: Healthfirst Essential Plan	$166,132.37
Rate for Payer: Healthfirst QHP	$127,198.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73,836.61
Rate for Payer: SOMOS Essential	$166,132.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$73,836.61

APR-DRG 0033: Bone marrow transplant

Facility IP

$327,690.00

Service Code	APR-DRG 0033
Min. Negotiated Rate	$105,591.75
Max. Negotiated Rate	$327,690.00
Rate for Payer: Amida Care Medicaid	$105,591.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$105,591.75
Rate for Payer: Fidelis Qualified Health Plan	$126,710.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$105,591.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$105,591.75
Rate for Payer: Healthfirst Commercial	$327,690.00
Rate for Payer: Healthfirst Essential Plan	$237,581.44
Rate for Payer: Healthfirst QHP	$203,120.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$105,591.75
Rate for Payer: SOMOS Essential	$237,581.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105,591.75

APR-DRG 0034: Bone marrow transplant

Facility IP

$659,196.00

Service Code	APR-DRG 0034
Min. Negotiated Rate	$188,348.19
Max. Negotiated Rate	$659,196.00
Rate for Payer: Amida Care Medicaid	$188,348.19
Rate for Payer: Fidelis CHP/HARP/Medicaid	$188,348.19
Rate for Payer: Fidelis Qualified Health Plan	$226,017.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$188,348.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$188,348.19
Rate for Payer: Healthfirst Commercial	$659,196.00
Rate for Payer: Healthfirst Essential Plan	$423,783.43
Rate for Payer: Healthfirst QHP	$394,531.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$188,348.19
Rate for Payer: SOMOS Essential	$423,783.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$188,348.19

APR-DRG 0041: Tracheostomy w MV 96+ hours w extensive procedure or ECMO

Facility IP

$156,072.35

Service Code	APR-DRG 0041
Min. Negotiated Rate	$69,365.49
Max. Negotiated Rate	$156,072.35
Rate for Payer: Amida Care Medicaid	$69,365.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$69,365.49
Rate for Payer: Fidelis Qualified Health Plan	$83,238.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$69,365.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$69,365.49
Rate for Payer: Healthfirst Commercial	$133,863.00
Rate for Payer: Healthfirst Essential Plan	$156,072.35
Rate for Payer: Healthfirst QHP	$87,809.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69,365.49
Rate for Payer: SOMOS Essential	$156,072.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$69,365.49

APR-DRG 0042: Tracheostomy w MV 96+ hours w extensive procedure or ECMO

Facility IP

$156,072.35

Service Code	APR-DRG 0042
Min. Negotiated Rate	$69,365.49
Max. Negotiated Rate	$156,072.35
Rate for Payer: Amida Care Medicaid	$69,365.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$69,365.49
Rate for Payer: Fidelis Qualified Health Plan	$83,238.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$69,365.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$69,365.49
Rate for Payer: Healthfirst Commercial	$134,086.00
Rate for Payer: Healthfirst Essential Plan	$156,072.35
Rate for Payer: Healthfirst QHP	$89,139.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69,365.49
Rate for Payer: SOMOS Essential	$156,072.35
Rate for Payer: Wellcare CHP/FHP/Medicaid	$69,365.49

APR-DRG 0043: Tracheostomy w MV 96+ hours w extensive procedure or ECMO

Facility IP

$206,759.43

Service Code	APR-DRG 0043
Min. Negotiated Rate	$91,893.08
Max. Negotiated Rate	$206,759.43
Rate for Payer: Amida Care Medicaid	$91,893.08
Rate for Payer: Fidelis CHP/HARP/Medicaid	$91,893.08
Rate for Payer: Fidelis Qualified Health Plan	$110,271.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$91,893.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$91,893.08
Rate for Payer: Healthfirst Commercial	$189,011.00
Rate for Payer: Healthfirst Essential Plan	$206,759.43
Rate for Payer: Healthfirst QHP	$117,510.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$91,893.08
Rate for Payer: SOMOS Essential	$206,759.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$91,893.08

APR-DRG 0044: Tracheostomy w MV 96+ hours w extensive procedure or ECMO

Facility IP

$347,485.50

Service Code	APR-DRG 0044
Min. Negotiated Rate	$154,438.00
Max. Negotiated Rate	$347,485.50
Rate for Payer: Amida Care Medicaid	$154,438.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$154,438.00
Rate for Payer: Fidelis Qualified Health Plan	$185,325.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$154,438.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$154,438.00
Rate for Payer: Healthfirst Commercial	$321,497.00
Rate for Payer: Healthfirst Essential Plan	$347,485.50
Rate for Payer: Healthfirst QHP	$202,120.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$154,438.00
Rate for Payer: SOMOS Essential	$347,485.50
Rate for Payer: Wellcare CHP/FHP/Medicaid	$154,438.00

APR-DRG 0051: Tracheostomy w MV 96+ hours w/o extensive procedure

Facility IP

$129,823.06

Service Code	APR-DRG 0051
Min. Negotiated Rate	$57,699.14
Max. Negotiated Rate	$129,823.06
Rate for Payer: Amida Care Medicaid	$57,699.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$57,699.14
Rate for Payer: Fidelis Qualified Health Plan	$69,238.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$57,699.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$57,699.14
Rate for Payer: Healthfirst Commercial	$107,519.00
Rate for Payer: Healthfirst Essential Plan	$129,823.06
Rate for Payer: Healthfirst QHP	$66,804.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$57,699.14
Rate for Payer: SOMOS Essential	$129,823.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$57,699.14

APR-DRG 0052: Tracheostomy w MV 96+ hours w/o extensive procedure

Facility IP

$132,417.22

Service Code	APR-DRG 0052
Min. Negotiated Rate	$58,852.10
Max. Negotiated Rate	$132,417.22
Rate for Payer: Amida Care Medicaid	$58,852.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$58,852.10
Rate for Payer: Fidelis Qualified Health Plan	$70,622.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$58,852.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58,852.10
Rate for Payer: Healthfirst Commercial	$110,713.00
Rate for Payer: Healthfirst Essential Plan	$132,417.22
Rate for Payer: Healthfirst QHP	$69,079.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58,852.10
Rate for Payer: SOMOS Essential	$132,417.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$58,852.10

APR-DRG 0053: Tracheostomy w MV 96+ hours w/o extensive procedure

Facility IP

$192,022.88

Service Code	APR-DRG 0053
Min. Negotiated Rate	$85,343.50
Max. Negotiated Rate	$192,022.88
Rate for Payer: Amida Care Medicaid	$85,343.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$85,343.50
Rate for Payer: Fidelis Qualified Health Plan	$102,412.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$85,343.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$85,343.50
Rate for Payer: Healthfirst Commercial	$163,828.00
Rate for Payer: Healthfirst Essential Plan	$192,022.88
Rate for Payer: Healthfirst QHP	$97,208.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$85,343.50
Rate for Payer: SOMOS Essential	$192,022.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$85,343.50

APR-DRG 0054: Tracheostomy w MV 96+ hours w/o extensive procedure

Facility IP

$272,165.44

Service Code	APR-DRG 0054
Min. Negotiated Rate	$120,962.42
Max. Negotiated Rate	$272,165.44
Rate for Payer: Amida Care Medicaid	$120,962.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$120,962.42
Rate for Payer: Fidelis Qualified Health Plan	$145,154.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$120,962.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$120,962.42
Rate for Payer: Healthfirst Commercial	$235,733.00
Rate for Payer: Healthfirst Essential Plan	$272,165.44
Rate for Payer: Healthfirst QHP	$146,282.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120,962.42
Rate for Payer: SOMOS Essential	$272,165.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$120,962.42

APR-DRG 0061: Pancreas transplant

Facility IP

$199,383.00

Service Code	APR-DRG 0061
Min. Negotiated Rate	$52,691.01
Max. Negotiated Rate	$199,383.00
Rate for Payer: Amida Care Medicaid	$52,691.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52,691.01
Rate for Payer: Fidelis Qualified Health Plan	$63,229.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$52,691.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52,691.01
Rate for Payer: Healthfirst Commercial	$199,383.00
Rate for Payer: Healthfirst Essential Plan	$118,554.77
Rate for Payer: Healthfirst QHP	$99,982.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52,691.01
Rate for Payer: SOMOS Essential	$118,554.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$52,691.01

APR-DRG 0062: Pancreas transplant

Facility IP

$199,383.00

Service Code	APR-DRG 0062
Min. Negotiated Rate	$52,691.01
Max. Negotiated Rate	$199,383.00
Rate for Payer: Amida Care Medicaid	$52,691.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$52,691.01
Rate for Payer: Fidelis Qualified Health Plan	$63,229.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$52,691.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52,691.01
Rate for Payer: Healthfirst Commercial	$199,383.00
Rate for Payer: Healthfirst Essential Plan	$118,554.77
Rate for Payer: Healthfirst QHP	$99,982.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52,691.01
Rate for Payer: SOMOS Essential	$118,554.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$52,691.01

APR-DRG 0063: Pancreas transplant

Facility IP

$207,018.00

Service Code	APR-DRG 0063
Min. Negotiated Rate	$70,347.26
Max. Negotiated Rate	$207,018.00
Rate for Payer: Amida Care Medicaid	$70,347.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$70,347.26
Rate for Payer: Fidelis Qualified Health Plan	$84,416.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$70,347.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$70,347.26
Rate for Payer: Healthfirst Commercial	$207,018.00
Rate for Payer: Healthfirst Essential Plan	$158,281.34
Rate for Payer: Healthfirst QHP	$121,196.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70,347.26
Rate for Payer: SOMOS Essential	$158,281.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$70,347.26

APR-DRG 0064: Pancreas transplant

Facility IP

$230,289.00

Service Code	APR-DRG 0064
Min. Negotiated Rate	$72,885.33
Max. Negotiated Rate	$230,289.00
Rate for Payer: Amida Care Medicaid	$72,885.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$72,885.33
Rate for Payer: Fidelis Qualified Health Plan	$87,462.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$72,885.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$72,885.33
Rate for Payer: Healthfirst Commercial	$230,289.00
Rate for Payer: Healthfirst Essential Plan	$163,991.99
Rate for Payer: Healthfirst QHP	$162,943.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$72,885.33
Rate for Payer: SOMOS Essential	$163,991.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$72,885.33

APR-DRG 0201: Craniotomy for trauma

Facility IP

$61,047.29

Service Code	APR-DRG 0201
Min. Negotiated Rate	$21,375.00
Max. Negotiated Rate	$61,047.29
Rate for Payer: Amida Care Medicaid	$27,132.13
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,132.13
Rate for Payer: Fidelis Qualified Health Plan	$32,558.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,132.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,132.13
Rate for Payer: Healthfirst Commercial	$34,643.00
Rate for Payer: Healthfirst Essential Plan	$61,047.29
Rate for Payer: Healthfirst QHP	$21,375.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,132.13
Rate for Payer: SOMOS Essential	$61,047.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,132.13

APR-DRG 0202: Craniotomy for trauma

Facility IP

$69,309.88

Service Code	APR-DRG 0202
Min. Negotiated Rate	$26,448.00
Max. Negotiated Rate	$69,309.88
Rate for Payer: Amida Care Medicaid	$30,804.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,804.39
Rate for Payer: Fidelis Qualified Health Plan	$36,965.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,804.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,804.39
Rate for Payer: Healthfirst Commercial	$42,479.00
Rate for Payer: Healthfirst Essential Plan	$69,309.88
Rate for Payer: Healthfirst QHP	$26,448.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,804.39
Rate for Payer: SOMOS Essential	$69,309.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,804.39

APR-DRG 0203: Craniotomy for trauma

Facility IP

$91,944.94

Service Code	APR-DRG 0203
Min. Negotiated Rate	$40,864.42
Max. Negotiated Rate	$91,944.94
Rate for Payer: Amida Care Medicaid	$40,864.42
Rate for Payer: Fidelis CHP/HARP/Medicaid	$40,864.42
Rate for Payer: Fidelis Qualified Health Plan	$49,037.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$40,864.42
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40,864.42
Rate for Payer: Healthfirst Commercial	$66,695.00
Rate for Payer: Healthfirst Essential Plan	$91,944.94
Rate for Payer: Healthfirst QHP	$43,250.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40,864.42
Rate for Payer: SOMOS Essential	$91,944.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40,864.42

APR-DRG 0204: Craniotomy for trauma

Facility IP

$147,303.25

Service Code	APR-DRG 0204
Min. Negotiated Rate	$65,468.11
Max. Negotiated Rate	$147,303.25
Rate for Payer: Amida Care Medicaid	$65,468.11
Rate for Payer: Fidelis CHP/HARP/Medicaid	$65,468.11
Rate for Payer: Fidelis Qualified Health Plan	$78,561.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$65,468.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$65,468.11
Rate for Payer: Healthfirst Commercial	$117,809.00
Rate for Payer: Healthfirst Essential Plan	$147,303.25
Rate for Payer: Healthfirst QHP	$74,119.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65,468.11
Rate for Payer: SOMOS Essential	$147,303.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$65,468.11

APR-DRG 0211: Craniotomy except for trauma

Facility IP

$62,955.54

Service Code	APR-DRG 0211
Min. Negotiated Rate	$22,834.00
Max. Negotiated Rate	$62,955.54
Rate for Payer: Amida Care Medicaid	$27,980.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27,980.24
Rate for Payer: Fidelis Qualified Health Plan	$33,576.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$27,980.24
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27,980.24
Rate for Payer: Healthfirst Commercial	$35,835.00
Rate for Payer: Healthfirst Essential Plan	$62,955.54
Rate for Payer: Healthfirst QHP	$22,834.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27,980.24
Rate for Payer: SOMOS Essential	$62,955.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27,980.24

APR-DRG 0212: Craniotomy except for trauma

Facility IP

$76,728.28

Service Code	APR-DRG 0212
Min. Negotiated Rate	$30,190.00
Max. Negotiated Rate	$76,728.28
Rate for Payer: Amida Care Medicaid	$34,101.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,101.46
Rate for Payer: Fidelis Qualified Health Plan	$40,921.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,101.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,101.46
Rate for Payer: Healthfirst Commercial	$49,085.00
Rate for Payer: Healthfirst Essential Plan	$76,728.28
Rate for Payer: Healthfirst QHP	$30,190.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,101.46
Rate for Payer: SOMOS Essential	$76,728.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,101.46

APR-DRG 0213: Craniotomy except for trauma

Facility IP

$105,830.26

Service Code	APR-DRG 0213
Min. Negotiated Rate	$47,035.67
Max. Negotiated Rate	$105,830.26
Rate for Payer: Amida Care Medicaid	$47,035.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$47,035.67
Rate for Payer: Fidelis Qualified Health Plan	$56,442.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$47,035.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$47,035.67
Rate for Payer: Healthfirst Commercial	$78,526.00
Rate for Payer: Healthfirst Essential Plan	$105,830.26
Rate for Payer: Healthfirst QHP	$52,885.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47,035.67
Rate for Payer: SOMOS Essential	$105,830.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$47,035.67

APR-DRG 0214: Craniotomy except for trauma

Facility IP

$157,000.97

Service Code	APR-DRG 0214
Min. Negotiated Rate	$69,778.21
Max. Negotiated Rate	$157,000.97
Rate for Payer: Amida Care Medicaid	$69,778.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$69,778.21
Rate for Payer: Fidelis Qualified Health Plan	$83,733.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$69,778.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$69,778.21
Rate for Payer: Healthfirst Commercial	$135,401.00
Rate for Payer: Healthfirst Essential Plan	$157,000.97
Rate for Payer: Healthfirst QHP	$96,015.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69,778.21
Rate for Payer: SOMOS Essential	$157,000.97
Rate for Payer: Wellcare CHP/FHP/Medicaid	$69,778.21

APR-DRG 0221: Ventricular shunt procedures

Facility IP

$52,063.63

Service Code	APR-DRG 0221
Min. Negotiated Rate	$14,809.00
Max. Negotiated Rate	$52,063.63
Rate for Payer: Amida Care Medicaid	$23,139.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,139.39
Rate for Payer: Fidelis Qualified Health Plan	$27,767.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,139.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,139.39
Rate for Payer: Healthfirst Commercial	$23,531.00
Rate for Payer: Healthfirst Essential Plan	$52,063.63
Rate for Payer: Healthfirst QHP	$14,809.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,139.39
Rate for Payer: SOMOS Essential	$52,063.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,139.39

APR-DRG 0222: Ventricular shunt procedures

Facility IP

$58,310.68

Service Code	APR-DRG 0222
Min. Negotiated Rate	$21,406.00
Max. Negotiated Rate	$58,310.68
Rate for Payer: Amida Care Medicaid	$25,915.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,915.86
Rate for Payer: Fidelis Qualified Health Plan	$31,099.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,915.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,915.86
Rate for Payer: Healthfirst Commercial	$34,917.00
Rate for Payer: Healthfirst Essential Plan	$58,310.68
Rate for Payer: Healthfirst QHP	$21,406.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,915.86
Rate for Payer: SOMOS Essential	$58,310.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,915.86

Price Transparency.

All Charges