|
Other aftercare & convalescence
|
Facility
|
IP
|
$41,023.21
|
|
|
Service Code
|
APR-DRG 8621
|
| Min. Negotiated Rate |
$6,547.00 |
| Max. Negotiated Rate |
$41,023.21 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,023.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,023.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,232.54
|
| Rate for Payer: Amida Care Medicaid |
$18,232.54
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,023.21
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,232.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,232.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,879.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,232.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,232.54
|
| Rate for Payer: Healthfirst Commercial |
$10,707.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,023.21
|
| Rate for Payer: Healthfirst QHP |
$6,547.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,232.54
|
| Rate for Payer: SOMOS Essential |
$41,023.21
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,023.21
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,023.21
|
| Rate for Payer: United Healthcare Medicaid |
$18,232.54
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,232.54
|
|
|
Other anemia & disorders of blood & blood-forming organs
|
Facility
|
IP
|
$41,044.32
|
|
|
Service Code
|
APR-DRG 6631
|
| Min. Negotiated Rate |
$6,039.00 |
| Max. Negotiated Rate |
$41,044.32 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,044.32
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,044.32
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,241.92
|
| Rate for Payer: Amida Care Medicaid |
$18,241.92
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,044.32
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,241.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,241.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,890.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,241.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,241.92
|
| Rate for Payer: Healthfirst Commercial |
$10,238.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,044.32
|
| Rate for Payer: Healthfirst QHP |
$6,039.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,241.92
|
| Rate for Payer: SOMOS Essential |
$41,044.32
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,044.32
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,044.32
|
| Rate for Payer: United Healthcare Medicaid |
$18,241.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,241.92
|
|
|
Other anemia & disorders of blood & blood-forming organs
|
Facility
|
IP
|
$51,545.79
|
|
|
Service Code
|
APR-DRG 6633
|
| Min. Negotiated Rate |
$11,012.00 |
| Max. Negotiated Rate |
$51,545.79 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,545.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,545.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,909.24
|
| Rate for Payer: Amida Care Medicaid |
$22,909.24
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,545.79
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,909.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,909.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,491.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,909.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,909.24
|
| Rate for Payer: Healthfirst Commercial |
$19,159.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,545.79
|
| Rate for Payer: Healthfirst QHP |
$11,012.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,909.24
|
| Rate for Payer: SOMOS Essential |
$51,545.79
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,545.79
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,545.79
|
| Rate for Payer: United Healthcare Medicaid |
$22,909.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,909.24
|
|
|
Other anemia & disorders of blood & blood-forming organs
|
Facility
|
IP
|
$73,442.18
|
|
|
Service Code
|
APR-DRG 6634
|
| Min. Negotiated Rate |
$22,326.00 |
| Max. Negotiated Rate |
$73,442.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$73,442.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$73,442.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$32,640.97
|
| Rate for Payer: Amida Care Medicaid |
$32,640.97
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$73,442.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$32,640.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32,640.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39,169.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32,640.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32,640.97
|
| Rate for Payer: Healthfirst Commercial |
$35,258.00
|
| Rate for Payer: Healthfirst Essential Plan |
$73,442.18
|
| Rate for Payer: Healthfirst QHP |
$22,326.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32,640.97
|
| Rate for Payer: SOMOS Essential |
$73,442.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$73,442.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$73,442.18
|
| Rate for Payer: United Healthcare Medicaid |
$32,640.97
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$32,640.97
|
|
|
Other anemia & disorders of blood & blood-forming organs
|
Facility
|
IP
|
$44,408.79
|
|
|
Service Code
|
APR-DRG 6632
|
| Min. Negotiated Rate |
$7,673.00 |
| Max. Negotiated Rate |
$44,408.79 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,408.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,408.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,737.24
|
| Rate for Payer: Amida Care Medicaid |
$19,737.24
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,408.79
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,737.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,737.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,684.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,737.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,737.24
|
| Rate for Payer: Healthfirst Commercial |
$13,211.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,408.79
|
| Rate for Payer: Healthfirst QHP |
$7,673.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,737.24
|
| Rate for Payer: SOMOS Essential |
$44,408.79
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,408.79
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,408.79
|
| Rate for Payer: United Healthcare Medicaid |
$19,737.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,737.24
|
|
|
Other antepartum diagnoses
|
Facility
|
IP
|
$8,429.00
|
|
|
Service Code
|
APR-DRG 5661
|
| Min. Negotiated Rate |
$3,292.56 |
| Max. Negotiated Rate |
$8,429.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,292.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,292.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,292.56
|
| Rate for Payer: Carelon Behavioral Health HARP/QHP |
$3,292.56
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$7,408.26
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$3,292.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,951.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,292.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,292.56
|
| Rate for Payer: Healthfirst Commercial |
$8,429.00
|
| Rate for Payer: Healthfirst Essential Plan |
$7,408.26
|
| Rate for Payer: Healthfirst QHP |
$5,992.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,292.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7,408.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7,408.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,292.56
|
| Rate for Payer: SOMOS Essential |
$7,408.26
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$7,408.26
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$7,408.26
|
| Rate for Payer: United Healthcare Medicaid |
$3,292.56
|
|
|
Other antepartum diagnoses
|
Facility
|
IP
|
$9,733.00
|
|
|
Service Code
|
APR-DRG 5662
|
| Min. Negotiated Rate |
$3,292.56 |
| Max. Negotiated Rate |
$9,733.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,292.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,292.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,292.56
|
| Rate for Payer: Carelon Behavioral Health HARP/QHP |
$3,292.56
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$7,408.26
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$3,292.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,951.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,292.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,292.56
|
| Rate for Payer: Healthfirst Commercial |
$9,733.00
|
| Rate for Payer: Healthfirst Essential Plan |
$7,408.26
|
| Rate for Payer: Healthfirst QHP |
$5,992.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,292.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7,408.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7,408.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,292.56
|
| Rate for Payer: SOMOS Essential |
$7,408.26
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$7,408.26
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$7,408.26
|
| Rate for Payer: United Healthcare Medicaid |
$3,292.56
|
|
|
Other antepartum diagnoses
|
Facility
|
IP
|
$13,472.00
|
|
|
Service Code
|
APR-DRG 5663
|
| Min. Negotiated Rate |
$3,434.67 |
| Max. Negotiated Rate |
$13,472.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,434.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,434.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,434.67
|
| Rate for Payer: Carelon Behavioral Health HARP/QHP |
$3,434.67
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$7,728.01
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$3,434.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,121.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,434.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,434.67
|
| Rate for Payer: Healthfirst Commercial |
$13,472.00
|
| Rate for Payer: Healthfirst Essential Plan |
$7,728.01
|
| Rate for Payer: Healthfirst QHP |
$6,251.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,434.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7,728.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7,728.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,434.67
|
| Rate for Payer: SOMOS Essential |
$7,728.01
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$7,728.01
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$7,728.01
|
| Rate for Payer: United Healthcare Medicaid |
$3,434.67
|
|
|
Other antepartum diagnoses
|
Facility
|
IP
|
$24,533.00
|
|
|
Service Code
|
APR-DRG 5664
|
| Min. Negotiated Rate |
$3,434.67 |
| Max. Negotiated Rate |
$24,533.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,434.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,434.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,434.67
|
| Rate for Payer: Carelon Behavioral Health HARP/QHP |
$3,434.67
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$7,728.01
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$3,434.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,121.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,434.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,434.67
|
| Rate for Payer: Healthfirst Commercial |
$24,533.00
|
| Rate for Payer: Healthfirst Essential Plan |
$7,728.01
|
| Rate for Payer: Healthfirst QHP |
$6,251.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,434.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7,728.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7,728.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,434.67
|
| Rate for Payer: SOMOS Essential |
$7,728.01
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$7,728.01
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$7,728.01
|
| Rate for Payer: United Healthcare Medicaid |
$3,434.67
|
|
|
OTHER ANTEPARTUM DIAGNOSES
|
Facility
|
OP
|
$244.48
|
|
|
Service Code
|
EAPG 00765
|
| Min. Negotiated Rate |
$178.20 |
| Max. Negotiated Rate |
$244.48 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$178.20
|
| Rate for Payer: Healthfirst Commercial |
$244.48
|
|
|
Other back & neck disorders, fractures & injuries
|
Facility
|
IP
|
$45,114.05
|
|
|
Service Code
|
APR-DRG 3472
|
| Min. Negotiated Rate |
$8,196.00 |
| Max. Negotiated Rate |
$45,114.05 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,114.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,114.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,050.69
|
| Rate for Payer: Amida Care Medicaid |
$20,050.69
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,114.05
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,050.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,050.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,060.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,050.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,050.69
|
| Rate for Payer: Healthfirst Commercial |
$13,775.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,114.05
|
| Rate for Payer: Healthfirst QHP |
$8,196.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,050.69
|
| Rate for Payer: SOMOS Essential |
$45,114.05
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,114.05
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,114.05
|
| Rate for Payer: United Healthcare Medicaid |
$20,050.69
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,050.69
|
|
|
Other back & neck disorders, fractures & injuries
|
Facility
|
IP
|
$87,510.40
|
|
|
Service Code
|
APR-DRG 3474
|
| Min. Negotiated Rate |
$30,805.00 |
| Max. Negotiated Rate |
$87,510.40 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$87,510.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$87,510.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$38,893.51
|
| Rate for Payer: Amida Care Medicaid |
$38,893.51
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$87,510.40
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$38,893.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38,893.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$46,672.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38,893.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38,893.51
|
| Rate for Payer: Healthfirst Commercial |
$51,812.00
|
| Rate for Payer: Healthfirst Essential Plan |
$87,510.40
|
| Rate for Payer: Healthfirst QHP |
$30,805.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38,893.51
|
| Rate for Payer: SOMOS Essential |
$87,510.40
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$87,510.40
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$87,510.40
|
| Rate for Payer: United Healthcare Medicaid |
$38,893.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$38,893.51
|
|
|
Other back & neck disorders, fractures & injuries
|
Facility
|
IP
|
$51,779.70
|
|
|
Service Code
|
APR-DRG 3473
|
| Min. Negotiated Rate |
$11,852.00 |
| Max. Negotiated Rate |
$51,779.70 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$51,779.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$51,779.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,013.20
|
| Rate for Payer: Amida Care Medicaid |
$23,013.20
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$51,779.70
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,013.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,013.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,615.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,013.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,013.20
|
| Rate for Payer: Healthfirst Commercial |
$20,252.00
|
| Rate for Payer: Healthfirst Essential Plan |
$51,779.70
|
| Rate for Payer: Healthfirst QHP |
$11,852.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,013.20
|
| Rate for Payer: SOMOS Essential |
$51,779.70
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$51,779.70
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$51,779.70
|
| Rate for Payer: United Healthcare Medicaid |
$23,013.20
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,013.20
|
|
|
Other back & neck disorders, fractures & injuries
|
Facility
|
IP
|
$41,673.94
|
|
|
Service Code
|
APR-DRG 3471
|
| Min. Negotiated Rate |
$6,279.00 |
| Max. Negotiated Rate |
$41,673.94 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,673.94
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,673.94
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,521.75
|
| Rate for Payer: Amida Care Medicaid |
$18,521.75
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,673.94
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,521.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,521.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,226.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,521.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,521.75
|
| Rate for Payer: Healthfirst Commercial |
$10,639.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,673.94
|
| Rate for Payer: Healthfirst QHP |
$6,279.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,521.75
|
| Rate for Payer: SOMOS Essential |
$41,673.94
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,673.94
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,673.94
|
| Rate for Payer: United Healthcare Medicaid |
$18,521.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,521.75
|
|
|
OTHER BEHAVIORAL HEALTH DIAGNOSES
|
Facility
|
OP
|
$211.05
|
|
|
Service Code
|
EAPG 00831
|
| Min. Negotiated Rate |
$152.74 |
| Max. Negotiated Rate |
$211.05 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$152.74
|
| Rate for Payer: Healthfirst Commercial |
$211.05
|
|
|
Other bladder procedures
|
Facility
|
IP
|
$46,463.02
|
|
|
Service Code
|
APR-DRG 4451
|
| Min. Negotiated Rate |
$8,222.00 |
| Max. Negotiated Rate |
$46,463.02 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$46,463.02
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$46,463.02
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,650.23
|
| Rate for Payer: Amida Care Medicaid |
$20,650.23
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$46,463.02
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,650.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,650.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,780.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,650.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,650.23
|
| Rate for Payer: Healthfirst Commercial |
$14,301.00
|
| Rate for Payer: Healthfirst Essential Plan |
$46,463.02
|
| Rate for Payer: Healthfirst QHP |
$8,222.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,650.23
|
| Rate for Payer: SOMOS Essential |
$46,463.02
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$46,463.02
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$46,463.02
|
| Rate for Payer: United Healthcare Medicaid |
$20,650.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,650.23
|
|
|
Other bladder procedures
|
Facility
|
IP
|
$54,336.92
|
|
|
Service Code
|
APR-DRG 4452
|
| Min. Negotiated Rate |
$13,123.00 |
| Max. Negotiated Rate |
$54,336.92 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$54,336.92
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$54,336.92
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24,149.74
|
| Rate for Payer: Amida Care Medicaid |
$24,149.74
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$54,336.92
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$24,149.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,149.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,979.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,149.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,149.74
|
| Rate for Payer: Healthfirst Commercial |
$22,612.00
|
| Rate for Payer: Healthfirst Essential Plan |
$54,336.92
|
| Rate for Payer: Healthfirst QHP |
$13,123.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,149.74
|
| Rate for Payer: SOMOS Essential |
$54,336.92
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$54,336.92
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$54,336.92
|
| Rate for Payer: United Healthcare Medicaid |
$24,149.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,149.74
|
|
|
Other bladder procedures
|
Facility
|
IP
|
$64,954.46
|
|
|
Service Code
|
APR-DRG 4453
|
| Min. Negotiated Rate |
$16,655.00 |
| Max. Negotiated Rate |
$64,954.46 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$64,954.46
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$64,954.46
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$28,868.65
|
| Rate for Payer: Amida Care Medicaid |
$28,868.65
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$64,954.46
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$28,868.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28,868.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34,642.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28,868.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28,868.65
|
| Rate for Payer: Healthfirst Commercial |
$33,678.00
|
| Rate for Payer: Healthfirst Essential Plan |
$64,954.46
|
| Rate for Payer: Healthfirst QHP |
$16,655.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28,868.65
|
| Rate for Payer: SOMOS Essential |
$64,954.46
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$64,954.46
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$64,954.46
|
| Rate for Payer: United Healthcare Medicaid |
$28,868.65
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28,868.65
|
|
|
Other bladder procedures
|
Facility
|
IP
|
$75,098.93
|
|
|
Service Code
|
APR-DRG 4454
|
| Min. Negotiated Rate |
$21,779.00 |
| Max. Negotiated Rate |
$75,098.93 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$75,098.93
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$75,098.93
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$33,377.30
|
| Rate for Payer: Amida Care Medicaid |
$33,377.30
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$75,098.93
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$33,377.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33,377.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40,052.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33,377.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33,377.30
|
| Rate for Payer: Healthfirst Commercial |
$43,972.00
|
| Rate for Payer: Healthfirst Essential Plan |
$75,098.93
|
| Rate for Payer: Healthfirst QHP |
$21,779.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33,377.30
|
| Rate for Payer: SOMOS Essential |
$75,098.93
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$75,098.93
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$75,098.93
|
| Rate for Payer: United Healthcare Medicaid |
$33,377.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33,377.30
|
|
|
Other cardiothoracic & thoracic vascular procedures
|
Facility
|
IP
|
$81,959.78
|
|
|
Service Code
|
APR-DRG 1672
|
| Min. Negotiated Rate |
$31,563.00 |
| Max. Negotiated Rate |
$81,959.78 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$81,959.78
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$81,959.78
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$36,426.57
|
| Rate for Payer: Amida Care Medicaid |
$36,426.57
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$81,959.78
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$36,426.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36,426.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$43,711.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36,426.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36,426.57
|
| Rate for Payer: Healthfirst Commercial |
$50,132.00
|
| Rate for Payer: Healthfirst Essential Plan |
$81,959.78
|
| Rate for Payer: Healthfirst QHP |
$31,563.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$36,426.57
|
| Rate for Payer: SOMOS Essential |
$81,959.78
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$81,959.78
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$81,959.78
|
| Rate for Payer: United Healthcare Medicaid |
$36,426.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$36,426.57
|
|
|
Other cardiothoracic & thoracic vascular procedures
|
Facility
|
IP
|
$148,642.65
|
|
|
Service Code
|
APR-DRG 1674
|
| Min. Negotiated Rate |
$66,063.40 |
| Max. Negotiated Rate |
$148,642.65 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$148,642.65
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$148,642.65
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$66,063.40
|
| Rate for Payer: Amida Care Medicaid |
$66,063.40
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$148,642.65
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$66,063.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$66,063.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$79,276.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$66,063.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$66,063.40
|
| Rate for Payer: Healthfirst Commercial |
$119,803.00
|
| Rate for Payer: Healthfirst Essential Plan |
$148,642.65
|
| Rate for Payer: Healthfirst QHP |
$69,036.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$66,063.40
|
| Rate for Payer: SOMOS Essential |
$148,642.65
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$148,642.65
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$148,642.65
|
| Rate for Payer: United Healthcare Medicaid |
$66,063.40
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$66,063.40
|
|
|
Other cardiothoracic & thoracic vascular procedures
|
Facility
|
IP
|
$74,678.58
|
|
|
Service Code
|
APR-DRG 1671
|
| Min. Negotiated Rate |
$25,501.00 |
| Max. Negotiated Rate |
$74,678.58 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$74,678.58
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$74,678.58
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$33,190.48
|
| Rate for Payer: Amida Care Medicaid |
$33,190.48
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$74,678.58
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$33,190.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33,190.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39,828.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33,190.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33,190.48
|
| Rate for Payer: Healthfirst Commercial |
$38,757.00
|
| Rate for Payer: Healthfirst Essential Plan |
$74,678.58
|
| Rate for Payer: Healthfirst QHP |
$25,501.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33,190.48
|
| Rate for Payer: SOMOS Essential |
$74,678.58
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$74,678.58
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$74,678.58
|
| Rate for Payer: United Healthcare Medicaid |
$33,190.48
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33,190.48
|
|
|
Other cardiothoracic & thoracic vascular procedures
|
Facility
|
IP
|
$96,759.63
|
|
|
Service Code
|
APR-DRG 1673
|
| Min. Negotiated Rate |
$40,259.00 |
| Max. Negotiated Rate |
$96,759.63 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$96,759.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$96,759.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$43,004.28
|
| Rate for Payer: Amida Care Medicaid |
$43,004.28
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$96,759.63
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$43,004.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$43,004.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$51,605.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43,004.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$43,004.28
|
| Rate for Payer: Healthfirst Commercial |
$61,936.00
|
| Rate for Payer: Healthfirst Essential Plan |
$96,759.63
|
| Rate for Payer: Healthfirst QHP |
$40,259.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$43,004.28
|
| Rate for Payer: SOMOS Essential |
$96,759.63
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$96,759.63
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$96,759.63
|
| Rate for Payer: United Healthcare Medicaid |
$43,004.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43,004.28
|
|
|
OTHER CARDIOVASCULAR SYSTEM DIAGNOSES
|
Facility
|
OP
|
$226.70
|
|
|
Service Code
|
EAPG 00592
|
| Min. Negotiated Rate |
$164.32 |
| Max. Negotiated Rate |
$226.70 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$164.32
|
| Rate for Payer: Healthfirst Commercial |
$226.70
|
|
|
OTHER CENTRAL NERVOUS SYSTEM DIAGNOSES
|
Facility
|
OP
|
$216.90
|
|
|
Service Code
|
EAPG 00524
|
| Min. Negotiated Rate |
$157.37 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$157.37
|
| Rate for Payer: Healthfirst Commercial |
$216.90
|
|
