St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

Other digestive system diagnoses

Facility

$53,343.22

Service Code	APR-DRG 2543
Min. Negotiated Rate	$11,515.00
Max. Negotiated Rate	$53,343.22
Rate for Payer: Affinity Essential Plan 1&2	$53,343.22
Rate for Payer: Affinity Essential Plan 3&4	$53,343.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,708.10
Rate for Payer: Amida Care Medicaid	$23,708.10
Rate for Payer: EmblemHealth Essential Plan 1&2	$53,343.22
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,708.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,708.10
Rate for Payer: Fidelis Qualified Health Plan	$28,449.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,708.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,708.10
Rate for Payer: Healthfirst Commercial	$20,319.00
Rate for Payer: Healthfirst Essential Plan	$53,343.22
Rate for Payer: Healthfirst QHP	$11,515.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,708.10
Rate for Payer: SOMOS Essential	$53,343.22
Rate for Payer: United Healthcare Essential Plan 1&2	$53,343.22
Rate for Payer: United Healthcare Essential Plan 3&4	$53,343.22
Rate for Payer: United Healthcare Medicaid	$23,708.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,708.10

Other disorders of nervous system

Facility

$91,608.28

Service Code	APR-DRG 0584
Min. Negotiated Rate	$28,694.00
Max. Negotiated Rate	$91,608.28
Rate for Payer: Affinity Essential Plan 1&2	$91,608.28
Rate for Payer: Affinity Essential Plan 3&4	$91,608.28
Rate for Payer: Affinity Medicaid/CHP/HARP	$40,714.79
Rate for Payer: Amida Care Medicaid	$40,714.79
Rate for Payer: EmblemHealth Essential Plan 1&2	$91,608.28
Rate for Payer: EmblemHealth Essential Plan 3&4	$40,714.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$40,714.79
Rate for Payer: Fidelis Qualified Health Plan	$48,857.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$40,714.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40,714.79
Rate for Payer: Healthfirst Commercial	$49,731.00
Rate for Payer: Healthfirst Essential Plan	$91,608.28
Rate for Payer: Healthfirst QHP	$28,694.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40,714.79
Rate for Payer: SOMOS Essential	$91,608.28
Rate for Payer: United Healthcare Essential Plan 1&2	$91,608.28
Rate for Payer: United Healthcare Essential Plan 3&4	$91,608.28
Rate for Payer: United Healthcare Medicaid	$40,714.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$40,714.79

Other disorders of nervous system

Facility

$41,487.53

Service Code	APR-DRG 0581
Min. Negotiated Rate	$6,448.00
Max. Negotiated Rate	$41,487.53
Rate for Payer: Affinity Essential Plan 1&2	$41,487.53
Rate for Payer: Affinity Essential Plan 3&4	$41,487.53
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,438.90
Rate for Payer: Amida Care Medicaid	$18,438.90
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,487.53
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,438.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,438.90
Rate for Payer: Fidelis Qualified Health Plan	$22,126.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,438.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,438.90
Rate for Payer: Healthfirst Commercial	$10,791.00
Rate for Payer: Healthfirst Essential Plan	$41,487.53
Rate for Payer: Healthfirst QHP	$6,448.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,438.90
Rate for Payer: SOMOS Essential	$41,487.53
Rate for Payer: United Healthcare Essential Plan 1&2	$41,487.53
Rate for Payer: United Healthcare Essential Plan 3&4	$41,487.53
Rate for Payer: United Healthcare Medicaid	$18,438.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,438.90

Other disorders of nervous system

Facility

$45,785.90

Service Code	APR-DRG 0582
Min. Negotiated Rate	$8,723.00
Max. Negotiated Rate	$45,785.90
Rate for Payer: Affinity Essential Plan 1&2	$45,785.90
Rate for Payer: Affinity Essential Plan 3&4	$45,785.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,349.29
Rate for Payer: Amida Care Medicaid	$20,349.29
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,785.90
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,349.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,349.29
Rate for Payer: Fidelis Qualified Health Plan	$24,419.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,349.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,349.29
Rate for Payer: Healthfirst Commercial	$14,441.00
Rate for Payer: Healthfirst Essential Plan	$45,785.90
Rate for Payer: Healthfirst QHP	$8,723.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,349.29
Rate for Payer: SOMOS Essential	$45,785.90
Rate for Payer: United Healthcare Essential Plan 1&2	$45,785.90
Rate for Payer: United Healthcare Essential Plan 3&4	$45,785.90
Rate for Payer: United Healthcare Medicaid	$20,349.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,349.29

Other disorders of nervous system

Facility

$54,252.50

Service Code	APR-DRG 0583
Min. Negotiated Rate	$12,885.00
Max. Negotiated Rate	$54,252.50
Rate for Payer: Affinity Essential Plan 1&2	$54,252.50
Rate for Payer: Affinity Essential Plan 3&4	$54,252.50
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,112.22
Rate for Payer: Amida Care Medicaid	$24,112.22
Rate for Payer: EmblemHealth Essential Plan 1&2	$54,252.50
Rate for Payer: EmblemHealth Essential Plan 3&4	$24,112.22
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,112.22
Rate for Payer: Fidelis Qualified Health Plan	$28,934.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,112.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,112.22
Rate for Payer: Healthfirst Commercial	$22,038.00
Rate for Payer: Healthfirst Essential Plan	$54,252.50
Rate for Payer: Healthfirst QHP	$12,885.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,112.22
Rate for Payer: SOMOS Essential	$54,252.50
Rate for Payer: United Healthcare Essential Plan 1&2	$54,252.50
Rate for Payer: United Healthcare Essential Plan 3&4	$54,252.50
Rate for Payer: United Healthcare Medicaid	$24,112.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,112.22

Other disorders of the liver

Facility

$45,159.77

Service Code	APR-DRG 2832
Min. Negotiated Rate	$8,240.00
Max. Negotiated Rate	$45,159.77
Rate for Payer: Affinity Essential Plan 1&2	$45,159.77
Rate for Payer: Affinity Essential Plan 3&4	$45,159.77
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,071.01
Rate for Payer: Amida Care Medicaid	$20,071.01
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,159.77
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,071.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,071.01
Rate for Payer: Fidelis Qualified Health Plan	$24,085.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,071.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,071.01
Rate for Payer: Healthfirst Commercial	$13,646.00
Rate for Payer: Healthfirst Essential Plan	$45,159.77
Rate for Payer: Healthfirst QHP	$8,240.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,071.01
Rate for Payer: SOMOS Essential	$45,159.77
Rate for Payer: United Healthcare Essential Plan 1&2	$45,159.77
Rate for Payer: United Healthcare Essential Plan 3&4	$45,159.77
Rate for Payer: United Healthcare Medicaid	$20,071.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,071.01

Other disorders of the liver

Facility

$77,562.92

Service Code	APR-DRG 2834
Min. Negotiated Rate	$26,638.00
Max. Negotiated Rate	$77,562.92
Rate for Payer: Affinity Essential Plan 1&2	$77,562.92
Rate for Payer: Affinity Essential Plan 3&4	$77,562.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,472.41
Rate for Payer: Amida Care Medicaid	$34,472.41
Rate for Payer: EmblemHealth Essential Plan 1&2	$77,562.92
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,472.41
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,472.41
Rate for Payer: Fidelis Qualified Health Plan	$41,366.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,472.41
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,472.41
Rate for Payer: Healthfirst Commercial	$46,116.00
Rate for Payer: Healthfirst Essential Plan	$77,562.92
Rate for Payer: Healthfirst QHP	$26,638.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,472.41
Rate for Payer: SOMOS Essential	$77,562.92
Rate for Payer: United Healthcare Essential Plan 1&2	$77,562.92
Rate for Payer: United Healthcare Essential Plan 3&4	$77,562.92
Rate for Payer: United Healthcare Medicaid	$34,472.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,472.41

Other disorders of the liver

Facility

$53,200.75

Service Code	APR-DRG 2833
Min. Negotiated Rate	$12,470.00
Max. Negotiated Rate	$53,200.75
Rate for Payer: Affinity Essential Plan 1&2	$53,200.75
Rate for Payer: Affinity Essential Plan 3&4	$53,200.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,644.78
Rate for Payer: Amida Care Medicaid	$23,644.78
Rate for Payer: EmblemHealth Essential Plan 1&2	$53,200.75
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,644.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,644.78
Rate for Payer: Fidelis Qualified Health Plan	$28,373.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,644.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,644.78
Rate for Payer: Healthfirst Commercial	$20,524.00
Rate for Payer: Healthfirst Essential Plan	$53,200.75
Rate for Payer: Healthfirst QHP	$12,470.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,644.78
Rate for Payer: SOMOS Essential	$53,200.75
Rate for Payer: United Healthcare Essential Plan 1&2	$53,200.75
Rate for Payer: United Healthcare Essential Plan 3&4	$53,200.75
Rate for Payer: United Healthcare Medicaid	$23,644.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,644.78

Other disorders of the liver

Facility

$41,928.95

Service Code	APR-DRG 2831
Min. Negotiated Rate	$5,995.00
Max. Negotiated Rate	$41,928.95
Rate for Payer: Affinity Essential Plan 1&2	$41,928.95
Rate for Payer: Affinity Essential Plan 3&4	$41,928.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,635.09
Rate for Payer: Amida Care Medicaid	$18,635.09
Rate for Payer: EmblemHealth Essential Plan 1&2	$41,928.95
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,635.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,635.09
Rate for Payer: Fidelis Qualified Health Plan	$22,362.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,635.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,635.09
Rate for Payer: Healthfirst Commercial	$11,057.00
Rate for Payer: Healthfirst Essential Plan	$41,928.95
Rate for Payer: Healthfirst QHP	$5,995.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,635.09
Rate for Payer: SOMOS Essential	$41,928.95
Rate for Payer: United Healthcare Essential Plan 1&2	$41,928.95
Rate for Payer: United Healthcare Essential Plan 3&4	$41,928.95
Rate for Payer: United Healthcare Medicaid	$18,635.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,635.09

OTHER DRUG ABUSE AND DEPENDENCE

Facility

$239.66

Service Code	EAPG 00843
Min. Negotiated Rate	$185.14
Max. Negotiated Rate	$239.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$185.14
Rate for Payer: Healthfirst Commercial	$239.66

Other drug abuse & dependence

Facility

$11,384.00

Service Code	APR-DRG 7762
Min. Negotiated Rate	$3,440.18
Max. Negotiated Rate	$11,384.00
Rate for Payer: Affinity Essential Plan 1&2	$3,440.18
Rate for Payer: Affinity Essential Plan 3&4	$3,440.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,440.18
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,440.18
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,740.40
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,440.18
Rate for Payer: Fidelis Qualified Health Plan	$4,128.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,440.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,440.18
Rate for Payer: Healthfirst Commercial	$11,384.00
Rate for Payer: Healthfirst Essential Plan	$7,740.40
Rate for Payer: Healthfirst QHP	$6,261.13
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,440.18
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,740.40
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,740.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,440.18
Rate for Payer: SOMOS Essential	$7,740.40
Rate for Payer: United Healthcare Essential Plan 1&2	$7,740.40
Rate for Payer: United Healthcare Essential Plan 3&4	$7,740.40
Rate for Payer: United Healthcare Medicaid	$3,440.18

Other drug abuse & dependence

Facility

$12,648.00

Service Code	APR-DRG 7764
Min. Negotiated Rate	$3,440.18
Max. Negotiated Rate	$12,648.00
Rate for Payer: Affinity Essential Plan 1&2	$3,440.18
Rate for Payer: Affinity Essential Plan 3&4	$3,440.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,440.18
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,440.18
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,740.40
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,440.18
Rate for Payer: Fidelis Qualified Health Plan	$4,128.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,440.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,440.18
Rate for Payer: Healthfirst Commercial	$12,648.00
Rate for Payer: Healthfirst Essential Plan	$7,740.40
Rate for Payer: Healthfirst QHP	$6,261.13
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,440.18
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,740.40
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,740.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,440.18
Rate for Payer: SOMOS Essential	$7,740.40
Rate for Payer: United Healthcare Essential Plan 1&2	$7,740.40
Rate for Payer: United Healthcare Essential Plan 3&4	$7,740.40
Rate for Payer: United Healthcare Medicaid	$3,440.18

Other drug abuse & dependence

Facility

$12,648.00

Service Code	APR-DRG 7763
Min. Negotiated Rate	$3,440.18
Max. Negotiated Rate	$12,648.00
Rate for Payer: Affinity Essential Plan 1&2	$3,440.18
Rate for Payer: Affinity Essential Plan 3&4	$3,440.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,440.18
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,440.18
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,740.40
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,440.18
Rate for Payer: Fidelis Qualified Health Plan	$4,128.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,440.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,440.18
Rate for Payer: Healthfirst Commercial	$12,648.00
Rate for Payer: Healthfirst Essential Plan	$7,740.40
Rate for Payer: Healthfirst QHP	$6,261.13
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,440.18
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,740.40
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,740.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,440.18
Rate for Payer: SOMOS Essential	$7,740.40
Rate for Payer: United Healthcare Essential Plan 1&2	$7,740.40
Rate for Payer: United Healthcare Essential Plan 3&4	$7,740.40
Rate for Payer: United Healthcare Medicaid	$3,440.18

Other drug abuse & dependence

Facility

$10,599.00

Service Code	APR-DRG 7761
Min. Negotiated Rate	$3,271.39
Max. Negotiated Rate	$10,599.00
Rate for Payer: Affinity Essential Plan 1&2	$3,271.39
Rate for Payer: Affinity Essential Plan 3&4	$3,271.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,271.39
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,271.39
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,360.63
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,271.39
Rate for Payer: Fidelis Qualified Health Plan	$3,925.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,271.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,271.39
Rate for Payer: Healthfirst Commercial	$10,599.00
Rate for Payer: Healthfirst Essential Plan	$7,360.63
Rate for Payer: Healthfirst QHP	$5,953.93
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,271.39
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,360.63
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,360.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,271.39
Rate for Payer: SOMOS Essential	$7,360.63
Rate for Payer: United Healthcare Essential Plan 1&2	$7,360.63
Rate for Payer: United Healthcare Essential Plan 3&4	$7,360.63
Rate for Payer: United Healthcare Medicaid	$3,271.39

OTHER EAR, NOSE, MOUTH, THROAT AND CRANIOFACIAL DIAGNOSES

Facility

$223.75

Service Code	EAPG 00564
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$223.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.00
Rate for Payer: Healthfirst Commercial	$223.75

Other ear, nose, mouth,throat & cranial/facial diagnoses

Facility

$42,593.76

Service Code	APR-DRG 1152
Min. Negotiated Rate	$6,565.00
Max. Negotiated Rate	$42,593.76
Rate for Payer: Affinity Essential Plan 1&2	$42,593.76
Rate for Payer: Affinity Essential Plan 3&4	$42,593.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,930.56
Rate for Payer: Amida Care Medicaid	$18,930.56
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,593.76
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,930.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,930.56
Rate for Payer: Fidelis Qualified Health Plan	$22,716.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,930.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,930.56
Rate for Payer: Healthfirst Commercial	$11,367.00
Rate for Payer: Healthfirst Essential Plan	$42,593.76
Rate for Payer: Healthfirst QHP	$6,565.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,930.56
Rate for Payer: SOMOS Essential	$42,593.76
Rate for Payer: United Healthcare Essential Plan 1&2	$42,593.76
Rate for Payer: United Healthcare Essential Plan 3&4	$42,593.76
Rate for Payer: United Healthcare Medicaid	$18,930.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,930.56

Other ear, nose, mouth,throat & cranial/facial diagnoses

Facility

$39,783.29

Service Code	APR-DRG 1151
Min. Negotiated Rate	$5,286.00
Max. Negotiated Rate	$39,783.29
Rate for Payer: Affinity Essential Plan 1&2	$39,783.29
Rate for Payer: Affinity Essential Plan 3&4	$39,783.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,681.46
Rate for Payer: Amida Care Medicaid	$17,681.46
Rate for Payer: EmblemHealth Essential Plan 1&2	$39,783.29
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,681.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,681.46
Rate for Payer: Fidelis Qualified Health Plan	$21,217.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,681.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,681.46
Rate for Payer: Healthfirst Commercial	$9,096.00
Rate for Payer: Healthfirst Essential Plan	$39,783.29
Rate for Payer: Healthfirst QHP	$5,286.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,681.46
Rate for Payer: SOMOS Essential	$39,783.29
Rate for Payer: United Healthcare Essential Plan 1&2	$39,783.29
Rate for Payer: United Healthcare Essential Plan 3&4	$39,783.29
Rate for Payer: United Healthcare Medicaid	$17,681.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,681.46

Other ear, nose, mouth,throat & cranial/facial diagnoses

Facility

$49,481.01

Service Code	APR-DRG 1153
Min. Negotiated Rate	$10,583.00
Max. Negotiated Rate	$49,481.01
Rate for Payer: Affinity Essential Plan 1&2	$49,481.01
Rate for Payer: Affinity Essential Plan 3&4	$49,481.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,991.56
Rate for Payer: Amida Care Medicaid	$21,991.56
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,481.01
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,991.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,991.56
Rate for Payer: Fidelis Qualified Health Plan	$26,389.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,991.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,991.56
Rate for Payer: Healthfirst Commercial	$18,509.00
Rate for Payer: Healthfirst Essential Plan	$49,481.01
Rate for Payer: Healthfirst QHP	$10,583.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,991.56
Rate for Payer: SOMOS Essential	$49,481.01
Rate for Payer: United Healthcare Essential Plan 1&2	$49,481.01
Rate for Payer: United Healthcare Essential Plan 3&4	$49,481.01
Rate for Payer: United Healthcare Medicaid	$21,991.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,991.56

Other ear, nose, mouth,throat & cranial/facial diagnoses

Facility

$78,127.47

Service Code	APR-DRG 1154
Min. Negotiated Rate	$21,178.00
Max. Negotiated Rate	$78,127.47
Rate for Payer: Affinity Essential Plan 1&2	$78,127.47
Rate for Payer: Affinity Essential Plan 3&4	$78,127.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$34,723.32
Rate for Payer: Amida Care Medicaid	$34,723.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$78,127.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$34,723.32
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,723.32
Rate for Payer: Fidelis Qualified Health Plan	$41,667.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,723.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,723.32
Rate for Payer: Healthfirst Commercial	$42,624.00
Rate for Payer: Healthfirst Essential Plan	$78,127.47
Rate for Payer: Healthfirst QHP	$21,178.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,723.32
Rate for Payer: SOMOS Essential	$78,127.47
Rate for Payer: United Healthcare Essential Plan 1&2	$78,127.47
Rate for Payer: United Healthcare Essential Plan 3&4	$78,127.47
Rate for Payer: United Healthcare Medicaid	$34,723.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,723.32

Other ear, nose, mouth & throat procedures

Facility

$44,058.80

Service Code	APR-DRG 0981
Min. Negotiated Rate	$7,790.00
Max. Negotiated Rate	$44,058.80
Rate for Payer: Affinity Essential Plan 1&2	$44,058.80
Rate for Payer: Affinity Essential Plan 3&4	$44,058.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,581.69
Rate for Payer: Amida Care Medicaid	$19,581.69
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,058.80
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,581.69
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,581.69
Rate for Payer: Fidelis Qualified Health Plan	$23,498.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,581.69
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,581.69
Rate for Payer: Healthfirst Commercial	$13,061.00
Rate for Payer: Healthfirst Essential Plan	$44,058.80
Rate for Payer: Healthfirst QHP	$7,790.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,581.69
Rate for Payer: SOMOS Essential	$44,058.80
Rate for Payer: United Healthcare Essential Plan 1&2	$44,058.80
Rate for Payer: United Healthcare Essential Plan 3&4	$44,058.80
Rate for Payer: United Healthcare Medicaid	$19,581.69
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,581.69

Other ear, nose, mouth & throat procedures

Facility

$49,169.72

Service Code	APR-DRG 0982
Min. Negotiated Rate	$10,153.00
Max. Negotiated Rate	$49,169.72
Rate for Payer: Affinity Essential Plan 1&2	$49,169.72
Rate for Payer: Affinity Essential Plan 3&4	$49,169.72
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,853.21
Rate for Payer: Amida Care Medicaid	$21,853.21
Rate for Payer: EmblemHealth Essential Plan 1&2	$49,169.72
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,853.21
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,853.21
Rate for Payer: Fidelis Qualified Health Plan	$26,223.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,853.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,853.21
Rate for Payer: Healthfirst Commercial	$17,532.00
Rate for Payer: Healthfirst Essential Plan	$49,169.72
Rate for Payer: Healthfirst QHP	$10,153.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,853.21
Rate for Payer: SOMOS Essential	$49,169.72
Rate for Payer: United Healthcare Essential Plan 1&2	$49,169.72
Rate for Payer: United Healthcare Essential Plan 3&4	$49,169.72
Rate for Payer: United Healthcare Medicaid	$21,853.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,853.21

Other ear, nose, mouth & throat procedures

Facility

$64,787.38

Service Code	APR-DRG 0983
Min. Negotiated Rate	$20,168.00
Max. Negotiated Rate	$64,787.38
Rate for Payer: Affinity Essential Plan 1&2	$64,787.38
Rate for Payer: Affinity Essential Plan 3&4	$64,787.38
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,794.39
Rate for Payer: Amida Care Medicaid	$28,794.39
Rate for Payer: EmblemHealth Essential Plan 1&2	$64,787.38
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,794.39
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,794.39
Rate for Payer: Fidelis Qualified Health Plan	$34,553.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,794.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,794.39
Rate for Payer: Healthfirst Commercial	$33,679.00
Rate for Payer: Healthfirst Essential Plan	$64,787.38
Rate for Payer: Healthfirst QHP	$20,168.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,794.39
Rate for Payer: SOMOS Essential	$64,787.38
Rate for Payer: United Healthcare Essential Plan 1&2	$64,787.38
Rate for Payer: United Healthcare Essential Plan 3&4	$64,787.38
Rate for Payer: United Healthcare Medicaid	$28,794.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,794.39

Other ear, nose, mouth & throat procedures

Facility

$105,206.90

Service Code	APR-DRG 0984
Min. Negotiated Rate	$44,320.00
Max. Negotiated Rate	$105,206.90
Rate for Payer: Affinity Essential Plan 1&2	$105,206.90
Rate for Payer: Affinity Essential Plan 3&4	$105,206.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$46,758.62
Rate for Payer: Amida Care Medicaid	$46,758.62
Rate for Payer: EmblemHealth Essential Plan 1&2	$105,206.90
Rate for Payer: EmblemHealth Essential Plan 3&4	$46,758.62
Rate for Payer: Fidelis CHP/HARP/Medicaid	$46,758.62
Rate for Payer: Fidelis Qualified Health Plan	$56,110.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$46,758.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$46,758.62
Rate for Payer: Healthfirst Commercial	$84,102.00
Rate for Payer: Healthfirst Essential Plan	$105,206.90
Rate for Payer: Healthfirst QHP	$44,320.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$46,758.62
Rate for Payer: SOMOS Essential	$105,206.90
Rate for Payer: United Healthcare Essential Plan 1&2	$105,206.90
Rate for Payer: United Healthcare Essential Plan 3&4	$105,206.90
Rate for Payer: United Healthcare Medicaid	$46,758.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$46,758.62

Other endocrine disorders

Facility

$45,372.58

Service Code	APR-DRG 4242
Min. Negotiated Rate	$8,144.00
Max. Negotiated Rate	$45,372.58
Rate for Payer: Affinity Essential Plan 1&2	$45,372.58
Rate for Payer: Affinity Essential Plan 3&4	$45,372.58
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,165.59
Rate for Payer: Amida Care Medicaid	$20,165.59
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,372.58
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,165.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,165.59
Rate for Payer: Fidelis Qualified Health Plan	$24,198.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,165.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,165.59
Rate for Payer: Healthfirst Commercial	$14,308.00
Rate for Payer: Healthfirst Essential Plan	$45,372.58
Rate for Payer: Healthfirst QHP	$8,144.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,165.59
Rate for Payer: SOMOS Essential	$45,372.58
Rate for Payer: United Healthcare Essential Plan 1&2	$45,372.58
Rate for Payer: United Healthcare Essential Plan 3&4	$45,372.58
Rate for Payer: United Healthcare Medicaid	$20,165.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,165.59

Other endocrine disorders

Facility

$80,964.34

Service Code	APR-DRG 4244
Min. Negotiated Rate	$26,490.00
Max. Negotiated Rate	$80,964.34
Rate for Payer: Affinity Essential Plan 1&2	$80,964.34
Rate for Payer: Affinity Essential Plan 3&4	$80,964.34
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,984.15
Rate for Payer: Amida Care Medicaid	$35,984.15
Rate for Payer: EmblemHealth Essential Plan 1&2	$80,964.34
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,984.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,984.15
Rate for Payer: Fidelis Qualified Health Plan	$43,180.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,984.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,984.15
Rate for Payer: Healthfirst Commercial	$44,433.00
Rate for Payer: Healthfirst Essential Plan	$80,964.34
Rate for Payer: Healthfirst QHP	$26,490.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,984.15
Rate for Payer: SOMOS Essential	$80,964.34
Rate for Payer: United Healthcare Essential Plan 1&2	$80,964.34
Rate for Payer: United Healthcare Essential Plan 3&4	$80,964.34
Rate for Payer: United Healthcare Medicaid	$35,984.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,984.15

Know your out-of-pocket cost for care.

All Charges