|
Other Chemotherapy #
|
Facility
|
IP
|
$58,661.66
|
|
|
Service Code
|
APR-DRG 6963
|
| Min. Negotiated Rate |
$26,071.85 |
| Max. Negotiated Rate |
$58,661.66 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$58,661.66
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$58,661.66
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$26,071.85
|
| Rate for Payer: Amida Care Medicaid |
$26,071.85
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$58,661.66
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$26,071.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26,071.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31,286.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26,071.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26,071.85
|
| Rate for Payer: Healthfirst Essential Plan |
$58,661.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26,071.85
|
| Rate for Payer: SOMOS Essential |
$58,661.66
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$58,661.66
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$58,661.66
|
| Rate for Payer: United Healthcare Medicaid |
$26,071.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$26,071.85
|
|
|
Other Chemotherapy #
|
Facility
|
IP
|
$49,681.51
|
|
|
Service Code
|
APR-DRG 6962
|
| Min. Negotiated Rate |
$22,080.67 |
| Max. Negotiated Rate |
$49,681.51 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$49,681.51
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$49,681.51
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,080.67
|
| Rate for Payer: Amida Care Medicaid |
$22,080.67
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$49,681.51
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,080.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,080.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26,496.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,080.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,080.67
|
| Rate for Payer: Healthfirst Essential Plan |
$49,681.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,080.67
|
| Rate for Payer: SOMOS Essential |
$49,681.51
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$49,681.51
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$49,681.51
|
| Rate for Payer: United Healthcare Medicaid |
$22,080.67
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,080.67
|
|
|
Other Chemotherapy #
|
Facility
|
IP
|
$109,303.02
|
|
|
Service Code
|
APR-DRG 6964
|
| Min. Negotiated Rate |
$48,579.12 |
| Max. Negotiated Rate |
$109,303.02 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$109,303.02
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$109,303.02
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$48,579.12
|
| Rate for Payer: Amida Care Medicaid |
$48,579.12
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$109,303.02
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$48,579.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$48,579.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$58,294.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48,579.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$48,579.12
|
| Rate for Payer: Healthfirst Essential Plan |
$109,303.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$48,579.12
|
| Rate for Payer: SOMOS Essential |
$109,303.02
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$109,303.02
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$109,303.02
|
| Rate for Payer: United Healthcare Medicaid |
$48,579.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$48,579.12
|
|
|
Other Chemotherapy #
|
Facility
|
IP
|
$45,152.75
|
|
|
Service Code
|
APR-DRG 6961
|
| Min. Negotiated Rate |
$20,067.89 |
| Max. Negotiated Rate |
$45,152.75 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,152.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,152.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,067.89
|
| Rate for Payer: Amida Care Medicaid |
$20,067.89
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,152.75
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,067.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,067.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,081.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,067.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,067.89
|
| Rate for Payer: Healthfirst Essential Plan |
$45,152.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,067.89
|
| Rate for Payer: SOMOS Essential |
$45,152.75
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,152.75
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,152.75
|
| Rate for Payer: United Healthcare Medicaid |
$20,067.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,067.89
|
|
|
Other circulatory system diagnoses
|
Facility
|
IP
|
$40,615.18
|
|
|
Service Code
|
APR-DRG 2071
|
| Min. Negotiated Rate |
$5,853.00 |
| Max. Negotiated Rate |
$40,615.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,615.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,615.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,051.19
|
| Rate for Payer: Amida Care Medicaid |
$18,051.19
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,615.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,051.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,051.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,661.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,051.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,051.19
|
| Rate for Payer: Healthfirst Commercial |
$10,123.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,615.18
|
| Rate for Payer: Healthfirst QHP |
$5,853.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,051.19
|
| Rate for Payer: SOMOS Essential |
$40,615.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,615.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,615.18
|
| Rate for Payer: United Healthcare Medicaid |
$18,051.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,051.19
|
|
|
Other circulatory system diagnoses
|
Facility
|
IP
|
$44,628.64
|
|
|
Service Code
|
APR-DRG 2072
|
| Min. Negotiated Rate |
$7,882.00 |
| Max. Negotiated Rate |
$44,628.64 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,628.64
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,628.64
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,834.95
|
| Rate for Payer: Amida Care Medicaid |
$19,834.95
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,628.64
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,834.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,834.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,801.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,834.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,834.95
|
| Rate for Payer: Healthfirst Commercial |
$13,675.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,628.64
|
| Rate for Payer: Healthfirst QHP |
$7,882.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,834.95
|
| Rate for Payer: SOMOS Essential |
$44,628.64
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,628.64
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,628.64
|
| Rate for Payer: United Healthcare Medicaid |
$19,834.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,834.95
|
|
|
Other circulatory system diagnoses
|
Facility
|
IP
|
$53,172.63
|
|
|
Service Code
|
APR-DRG 2073
|
| Min. Negotiated Rate |
$11,470.00 |
| Max. Negotiated Rate |
$53,172.63 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$53,172.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$53,172.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,632.28
|
| Rate for Payer: Amida Care Medicaid |
$23,632.28
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$53,172.63
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,632.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,632.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28,358.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,632.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,632.28
|
| Rate for Payer: Healthfirst Commercial |
$21,338.00
|
| Rate for Payer: Healthfirst Essential Plan |
$53,172.63
|
| Rate for Payer: Healthfirst QHP |
$11,470.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,632.28
|
| Rate for Payer: SOMOS Essential |
$53,172.63
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$53,172.63
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$53,172.63
|
| Rate for Payer: United Healthcare Medicaid |
$23,632.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,632.28
|
|
|
Other circulatory system diagnoses
|
Facility
|
IP
|
$76,460.18
|
|
|
Service Code
|
APR-DRG 2074
|
| Min. Negotiated Rate |
$20,117.00 |
| Max. Negotiated Rate |
$76,460.18 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$76,460.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$76,460.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$33,982.30
|
| Rate for Payer: Amida Care Medicaid |
$33,982.30
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$76,460.18
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$33,982.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33,982.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40,778.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33,982.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33,982.30
|
| Rate for Payer: Healthfirst Commercial |
$44,832.00
|
| Rate for Payer: Healthfirst Essential Plan |
$76,460.18
|
| Rate for Payer: Healthfirst QHP |
$20,117.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33,982.30
|
| Rate for Payer: SOMOS Essential |
$76,460.18
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$76,460.18
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$76,460.18
|
| Rate for Payer: United Healthcare Medicaid |
$33,982.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33,982.30
|
|
|
Other circulatory system procedures
|
Facility
|
IP
|
$74,569.52
|
|
|
Service Code
|
APR-DRG 1803
|
| Min. Negotiated Rate |
$29,867.00 |
| Max. Negotiated Rate |
$74,569.52 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$74,569.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$74,569.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$33,142.01
|
| Rate for Payer: Amida Care Medicaid |
$33,142.01
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$74,569.52
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$33,142.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33,142.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39,770.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33,142.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33,142.01
|
| Rate for Payer: Healthfirst Commercial |
$51,273.00
|
| Rate for Payer: Healthfirst Essential Plan |
$74,569.52
|
| Rate for Payer: Healthfirst QHP |
$29,867.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33,142.01
|
| Rate for Payer: SOMOS Essential |
$74,569.52
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$74,569.52
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$74,569.52
|
| Rate for Payer: United Healthcare Medicaid |
$33,142.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$33,142.01
|
|
|
Other circulatory system procedures
|
Facility
|
IP
|
$52,048.78
|
|
|
Service Code
|
APR-DRG 1801
|
| Min. Negotiated Rate |
$13,536.00 |
| Max. Negotiated Rate |
$52,048.78 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$52,048.78
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$52,048.78
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,132.79
|
| Rate for Payer: Amida Care Medicaid |
$23,132.79
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$52,048.78
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,132.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,132.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,759.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,132.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,132.79
|
| Rate for Payer: Healthfirst Commercial |
$23,162.00
|
| Rate for Payer: Healthfirst Essential Plan |
$52,048.78
|
| Rate for Payer: Healthfirst QHP |
$13,536.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,132.79
|
| Rate for Payer: SOMOS Essential |
$52,048.78
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$52,048.78
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$52,048.78
|
| Rate for Payer: United Healthcare Medicaid |
$23,132.79
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,132.79
|
|
|
Other circulatory system procedures
|
Facility
|
IP
|
$60,969.15
|
|
|
Service Code
|
APR-DRG 1802
|
| Min. Negotiated Rate |
$19,402.00 |
| Max. Negotiated Rate |
$60,969.15 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$60,969.15
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$60,969.15
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$27,097.40
|
| Rate for Payer: Amida Care Medicaid |
$27,097.40
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$60,969.15
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$27,097.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27,097.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32,516.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27,097.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27,097.40
|
| Rate for Payer: Healthfirst Commercial |
$32,071.00
|
| Rate for Payer: Healthfirst Essential Plan |
$60,969.15
|
| Rate for Payer: Healthfirst QHP |
$19,402.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27,097.40
|
| Rate for Payer: SOMOS Essential |
$60,969.15
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$60,969.15
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$60,969.15
|
| Rate for Payer: United Healthcare Medicaid |
$27,097.40
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$27,097.40
|
|
|
Other circulatory system procedures
|
Facility
|
IP
|
$116,772.41
|
|
|
Service Code
|
APR-DRG 1804
|
| Min. Negotiated Rate |
$51,898.85 |
| Max. Negotiated Rate |
$116,772.41 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$116,772.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$116,772.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$51,898.85
|
| Rate for Payer: Amida Care Medicaid |
$51,898.85
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$116,772.41
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$51,898.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$51,898.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$62,278.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51,898.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$51,898.85
|
| Rate for Payer: Healthfirst Commercial |
$93,996.00
|
| Rate for Payer: Healthfirst Essential Plan |
$116,772.41
|
| Rate for Payer: Healthfirst QHP |
$56,430.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$51,898.85
|
| Rate for Payer: SOMOS Essential |
$116,772.41
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$116,772.41
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$116,772.41
|
| Rate for Payer: United Healthcare Medicaid |
$51,898.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$51,898.85
|
|
|
Other complications of treatment
|
Facility
|
IP
|
$40,766.42
|
|
|
Service Code
|
APR-DRG 8131
|
| Min. Negotiated Rate |
$5,629.00 |
| Max. Negotiated Rate |
$40,766.42 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,766.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,766.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,118.41
|
| Rate for Payer: Amida Care Medicaid |
$18,118.41
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,766.42
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,118.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,118.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,742.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,118.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,118.41
|
| Rate for Payer: Healthfirst Commercial |
$10,152.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,766.42
|
| Rate for Payer: Healthfirst QHP |
$5,629.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,118.41
|
| Rate for Payer: SOMOS Essential |
$40,766.42
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,766.42
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,766.42
|
| Rate for Payer: United Healthcare Medicaid |
$18,118.41
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,118.41
|
|
|
Other complications of treatment
|
Facility
|
IP
|
$77,983.27
|
|
|
Service Code
|
APR-DRG 8134
|
| Min. Negotiated Rate |
$23,940.00 |
| Max. Negotiated Rate |
$77,983.27 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$77,983.27
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$77,983.27
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,659.23
|
| Rate for Payer: Amida Care Medicaid |
$34,659.23
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$77,983.27
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,659.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,659.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,591.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,659.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,659.23
|
| Rate for Payer: Healthfirst Commercial |
$44,596.00
|
| Rate for Payer: Healthfirst Essential Plan |
$77,983.27
|
| Rate for Payer: Healthfirst QHP |
$23,940.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,659.23
|
| Rate for Payer: SOMOS Essential |
$77,983.27
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$77,983.27
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$77,983.27
|
| Rate for Payer: United Healthcare Medicaid |
$34,659.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,659.23
|
|
|
Other complications of treatment
|
Facility
|
IP
|
$52,032.96
|
|
|
Service Code
|
APR-DRG 8133
|
| Min. Negotiated Rate |
$11,574.00 |
| Max. Negotiated Rate |
$52,032.96 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$52,032.96
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$52,032.96
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$23,125.76
|
| Rate for Payer: Amida Care Medicaid |
$23,125.76
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$52,032.96
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$23,125.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23,125.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27,750.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,125.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23,125.76
|
| Rate for Payer: Healthfirst Commercial |
$20,395.00
|
| Rate for Payer: Healthfirst Essential Plan |
$52,032.96
|
| Rate for Payer: Healthfirst QHP |
$11,574.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23,125.76
|
| Rate for Payer: SOMOS Essential |
$52,032.96
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$52,032.96
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$52,032.96
|
| Rate for Payer: United Healthcare Medicaid |
$23,125.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$23,125.76
|
|
|
Other complications of treatment
|
Facility
|
IP
|
$44,101.01
|
|
|
Service Code
|
APR-DRG 8132
|
| Min. Negotiated Rate |
$7,445.00 |
| Max. Negotiated Rate |
$44,101.01 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,101.01
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,101.01
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,600.45
|
| Rate for Payer: Amida Care Medicaid |
$19,600.45
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,101.01
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,600.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,600.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,520.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,600.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,600.45
|
| Rate for Payer: Healthfirst Commercial |
$13,122.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,101.01
|
| Rate for Payer: Healthfirst QHP |
$7,445.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,600.45
|
| Rate for Payer: SOMOS Essential |
$44,101.01
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,101.01
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,101.01
|
| Rate for Payer: United Healthcare Medicaid |
$19,600.45
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,600.45
|
|
|
OTHER COMPLICATIONS OF TREATMENT
|
Facility
|
OP
|
$274.69
|
|
|
Service Code
|
EAPG 00852
|
| Min. Negotiated Rate |
$199.03 |
| Max. Negotiated Rate |
$274.69 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$199.03
|
| Rate for Payer: Healthfirst Commercial |
$274.69
|
|
|
OTHER CRANIOTOMY PROCEDURES INCLUDING CRANIOPLASTY
|
Facility
|
OP
|
$3,411.28
|
|
|
Service Code
|
EAPG 00267
|
| Min. Negotiated Rate |
$3,411.28 |
| Max. Negotiated Rate |
$3,411.28 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,411.28
|
|
|
Other digestive system & abdominal procedures
|
Facility
|
IP
|
$49,978.73
|
|
|
Service Code
|
APR-DRG 2291
|
| Min. Negotiated Rate |
$12,328.00 |
| Max. Negotiated Rate |
$49,978.73 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$49,978.73
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$49,978.73
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$22,212.77
|
| Rate for Payer: Amida Care Medicaid |
$22,212.77
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$49,978.73
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$22,212.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22,212.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26,655.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22,212.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22,212.77
|
| Rate for Payer: Healthfirst Commercial |
$21,206.00
|
| Rate for Payer: Healthfirst Essential Plan |
$49,978.73
|
| Rate for Payer: Healthfirst QHP |
$12,328.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22,212.77
|
| Rate for Payer: SOMOS Essential |
$49,978.73
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$49,978.73
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$49,978.73
|
| Rate for Payer: United Healthcare Medicaid |
$22,212.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,212.77
|
|
|
Other digestive system & abdominal procedures
|
Facility
|
IP
|
$58,049.64
|
|
|
Service Code
|
APR-DRG 2292
|
| Min. Negotiated Rate |
$18,212.00 |
| Max. Negotiated Rate |
$58,049.64 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$58,049.64
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$58,049.64
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,799.84
|
| Rate for Payer: Amida Care Medicaid |
$25,799.84
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$58,049.64
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,799.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,799.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30,959.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,799.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,799.84
|
| Rate for Payer: Healthfirst Commercial |
$29,226.00
|
| Rate for Payer: Healthfirst Essential Plan |
$58,049.64
|
| Rate for Payer: Healthfirst QHP |
$18,212.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,799.84
|
| Rate for Payer: SOMOS Essential |
$58,049.64
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$58,049.64
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$58,049.64
|
| Rate for Payer: United Healthcare Medicaid |
$25,799.84
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,799.84
|
|
|
Other digestive system & abdominal procedures
|
Facility
|
IP
|
$77,844.31
|
|
|
Service Code
|
APR-DRG 2293
|
| Min. Negotiated Rate |
$30,371.00 |
| Max. Negotiated Rate |
$77,844.31 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$77,844.31
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$77,844.31
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,597.47
|
| Rate for Payer: Amida Care Medicaid |
$34,597.47
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$77,844.31
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,597.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,597.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,516.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,597.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,597.47
|
| Rate for Payer: Healthfirst Commercial |
$51,117.00
|
| Rate for Payer: Healthfirst Essential Plan |
$77,844.31
|
| Rate for Payer: Healthfirst QHP |
$30,371.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,597.47
|
| Rate for Payer: SOMOS Essential |
$77,844.31
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$77,844.31
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$77,844.31
|
| Rate for Payer: United Healthcare Medicaid |
$34,597.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,597.47
|
|
|
Other digestive system & abdominal procedures
|
Facility
|
IP
|
$133,791.80
|
|
|
Service Code
|
APR-DRG 2294
|
| Min. Negotiated Rate |
$59,463.02 |
| Max. Negotiated Rate |
$133,791.80 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$133,791.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$133,791.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$59,463.02
|
| Rate for Payer: Amida Care Medicaid |
$59,463.02
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$133,791.80
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$59,463.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$59,463.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$71,355.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59,463.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59,463.02
|
| Rate for Payer: Healthfirst Commercial |
$104,566.00
|
| Rate for Payer: Healthfirst Essential Plan |
$133,791.80
|
| Rate for Payer: Healthfirst QHP |
$61,492.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$59,463.02
|
| Rate for Payer: SOMOS Essential |
$133,791.80
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$133,791.80
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$133,791.80
|
| Rate for Payer: United Healthcare Medicaid |
$59,463.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$59,463.02
|
|
|
Other digestive system diagnoses
|
Facility
|
IP
|
$77,886.52
|
|
|
Service Code
|
APR-DRG 2544
|
| Min. Negotiated Rate |
$24,418.00 |
| Max. Negotiated Rate |
$77,886.52 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$77,886.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$77,886.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$34,616.23
|
| Rate for Payer: Amida Care Medicaid |
$34,616.23
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$77,886.52
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$34,616.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34,616.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41,539.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,616.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34,616.23
|
| Rate for Payer: Healthfirst Commercial |
$41,660.00
|
| Rate for Payer: Healthfirst Essential Plan |
$77,886.52
|
| Rate for Payer: Healthfirst QHP |
$24,418.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34,616.23
|
| Rate for Payer: SOMOS Essential |
$77,886.52
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$77,886.52
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$77,886.52
|
| Rate for Payer: United Healthcare Medicaid |
$34,616.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34,616.23
|
|
|
Other digestive system diagnoses
|
Facility
|
IP
|
$44,709.55
|
|
|
Service Code
|
APR-DRG 2542
|
| Min. Negotiated Rate |
$7,892.00 |
| Max. Negotiated Rate |
$44,709.55 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$44,709.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$44,709.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,870.91
|
| Rate for Payer: Amida Care Medicaid |
$19,870.91
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$44,709.55
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$19,870.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19,870.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23,845.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19,870.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19,870.91
|
| Rate for Payer: Healthfirst Commercial |
$13,329.00
|
| Rate for Payer: Healthfirst Essential Plan |
$44,709.55
|
| Rate for Payer: Healthfirst QHP |
$7,892.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19,870.91
|
| Rate for Payer: SOMOS Essential |
$44,709.55
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$44,709.55
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$44,709.55
|
| Rate for Payer: United Healthcare Medicaid |
$19,870.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$19,870.91
|
|
|
Other digestive system diagnoses
|
Facility
|
IP
|
$40,799.86
|
|
|
Service Code
|
APR-DRG 2541
|
| Min. Negotiated Rate |
$5,731.00 |
| Max. Negotiated Rate |
$40,799.86 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$40,799.86
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$40,799.86
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,133.27
|
| Rate for Payer: Amida Care Medicaid |
$18,133.27
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$40,799.86
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,133.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,133.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21,759.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,133.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,133.27
|
| Rate for Payer: Healthfirst Commercial |
$9,816.00
|
| Rate for Payer: Healthfirst Essential Plan |
$40,799.86
|
| Rate for Payer: Healthfirst QHP |
$5,731.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,133.27
|
| Rate for Payer: SOMOS Essential |
$40,799.86
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$40,799.86
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$40,799.86
|
| Rate for Payer: United Healthcare Medicaid |
$18,133.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,133.27
|
|
