St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OTHER INFECTIOUS AND PARASITIC DISEASES

Facility

$214.04

Service Code	EAPG 00809
Min. Negotiated Rate	$155.06
Max. Negotiated Rate	$214.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$155.06
Rate for Payer: Healthfirst Commercial	$214.04

Other infectious & parasitic diseases

Facility

$95,693.83

Service Code	APR-DRG 7244
Min. Negotiated Rate	$28,211.00
Max. Negotiated Rate	$95,693.83
Rate for Payer: Affinity Essential Plan 1&2	$95,693.83
Rate for Payer: Affinity Essential Plan 3&4	$95,693.83
Rate for Payer: Affinity Medicaid/CHP/HARP	$42,530.59
Rate for Payer: Amida Care Medicaid	$42,530.59
Rate for Payer: EmblemHealth Essential Plan 1&2	$95,693.83
Rate for Payer: EmblemHealth Essential Plan 3&4	$42,530.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$42,530.59
Rate for Payer: Fidelis Qualified Health Plan	$51,036.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$42,530.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42,530.59
Rate for Payer: Healthfirst Commercial	$53,889.00
Rate for Payer: Healthfirst Essential Plan	$95,693.83
Rate for Payer: Healthfirst QHP	$28,211.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42,530.59
Rate for Payer: SOMOS Essential	$95,693.83
Rate for Payer: United Healthcare Essential Plan 1&2	$95,693.83
Rate for Payer: United Healthcare Essential Plan 3&4	$95,693.83
Rate for Payer: United Healthcare Medicaid	$42,530.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$42,530.59

Other infectious & parasitic diseases

Facility

$43,379.93

Service Code	APR-DRG 7241
Min. Negotiated Rate	$7,062.00
Max. Negotiated Rate	$43,379.93
Rate for Payer: Affinity Essential Plan 1&2	$43,379.93
Rate for Payer: Affinity Essential Plan 3&4	$43,379.93
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,279.97
Rate for Payer: Amida Care Medicaid	$19,279.97
Rate for Payer: EmblemHealth Essential Plan 1&2	$43,379.93
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,279.97
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,279.97
Rate for Payer: Fidelis Qualified Health Plan	$23,135.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,279.97
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,279.97
Rate for Payer: Healthfirst Commercial	$12,468.00
Rate for Payer: Healthfirst Essential Plan	$43,379.93
Rate for Payer: Healthfirst QHP	$7,062.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,279.97
Rate for Payer: SOMOS Essential	$43,379.93
Rate for Payer: United Healthcare Essential Plan 1&2	$43,379.93
Rate for Payer: United Healthcare Essential Plan 3&4	$43,379.93
Rate for Payer: United Healthcare Medicaid	$19,279.97
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,279.97

Other infectious & parasitic diseases

Facility

$45,509.76

Service Code	APR-DRG 7242
Min. Negotiated Rate	$8,447.00
Max. Negotiated Rate	$45,509.76
Rate for Payer: Affinity Essential Plan 1&2	$45,509.76
Rate for Payer: Affinity Essential Plan 3&4	$45,509.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$20,226.56
Rate for Payer: Amida Care Medicaid	$20,226.56
Rate for Payer: EmblemHealth Essential Plan 1&2	$45,509.76
Rate for Payer: EmblemHealth Essential Plan 3&4	$20,226.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$20,226.56
Rate for Payer: Fidelis Qualified Health Plan	$24,271.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,226.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$20,226.56
Rate for Payer: Healthfirst Commercial	$14,245.00
Rate for Payer: Healthfirst Essential Plan	$45,509.76
Rate for Payer: Healthfirst QHP	$8,447.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20,226.56
Rate for Payer: SOMOS Essential	$45,509.76
Rate for Payer: United Healthcare Essential Plan 1&2	$45,509.76
Rate for Payer: United Healthcare Essential Plan 3&4	$45,509.76
Rate for Payer: United Healthcare Medicaid	$20,226.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20,226.56

Other infectious & parasitic diseases

Facility

$55,986.61

Service Code	APR-DRG 7243
Min. Negotiated Rate	$13,528.00
Max. Negotiated Rate	$55,986.61
Rate for Payer: Affinity Essential Plan 1&2	$55,986.61
Rate for Payer: Affinity Essential Plan 3&4	$55,986.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,882.94
Rate for Payer: Amida Care Medicaid	$24,882.94
Rate for Payer: EmblemHealth Essential Plan 1&2	$55,986.61
Rate for Payer: EmblemHealth Essential Plan 3&4	$24,882.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,882.94
Rate for Payer: Fidelis Qualified Health Plan	$29,859.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,882.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,882.94
Rate for Payer: Healthfirst Commercial	$23,343.00
Rate for Payer: Healthfirst Essential Plan	$55,986.61
Rate for Payer: Healthfirst QHP	$13,528.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,882.94
Rate for Payer: SOMOS Essential	$55,986.61
Rate for Payer: United Healthcare Essential Plan 1&2	$55,986.61
Rate for Payer: United Healthcare Essential Plan 3&4	$55,986.61
Rate for Payer: United Healthcare Medicaid	$24,882.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,882.94

OTHER INJURIES AND DISORDERS OF THE MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE

Facility

$333.78

Service Code	EAPG 00652
Min. Negotiated Rate	$243.00
Max. Negotiated Rate	$333.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$243.00
Rate for Payer: Healthfirst Commercial	$333.78

OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES

Facility

$287.09

Service Code	EAPG 00853
Min. Negotiated Rate	$208.29
Max. Negotiated Rate	$287.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$208.29
Rate for Payer: Healthfirst Commercial	$287.09

Other injury, poisoning & toxic effect diagnoses

Facility

$42,885.72

Service Code	APR-DRG 8152
Min. Negotiated Rate	$6,595.00
Max. Negotiated Rate	$42,885.72
Rate for Payer: Affinity Essential Plan 1&2	$42,885.72
Rate for Payer: Affinity Essential Plan 3&4	$42,885.72
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,060.32
Rate for Payer: Amida Care Medicaid	$19,060.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$42,885.72
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,060.32
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,060.32
Rate for Payer: Fidelis Qualified Health Plan	$22,872.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,060.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,060.32
Rate for Payer: Healthfirst Commercial	$10,791.00
Rate for Payer: Healthfirst Essential Plan	$42,885.72
Rate for Payer: Healthfirst QHP	$6,595.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,060.32
Rate for Payer: SOMOS Essential	$42,885.72
Rate for Payer: United Healthcare Essential Plan 1&2	$42,885.72
Rate for Payer: United Healthcare Essential Plan 3&4	$42,885.72
Rate for Payer: United Healthcare Medicaid	$19,060.32
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,060.32

Other injury, poisoning & toxic effect diagnoses

Facility

$79,581.96

Service Code	APR-DRG 8154
Min. Negotiated Rate	$25,346.00
Max. Negotiated Rate	$79,581.96
Rate for Payer: Affinity Essential Plan 1&2	$79,581.96
Rate for Payer: Affinity Essential Plan 3&4	$79,581.96
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,369.76
Rate for Payer: Amida Care Medicaid	$35,369.76
Rate for Payer: EmblemHealth Essential Plan 1&2	$79,581.96
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,369.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,369.76
Rate for Payer: Fidelis Qualified Health Plan	$42,443.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,369.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,369.76
Rate for Payer: Healthfirst Commercial	$42,388.00
Rate for Payer: Healthfirst Essential Plan	$79,581.96
Rate for Payer: Healthfirst QHP	$25,346.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,369.76
Rate for Payer: SOMOS Essential	$79,581.96
Rate for Payer: United Healthcare Essential Plan 1&2	$79,581.96
Rate for Payer: United Healthcare Essential Plan 3&4	$79,581.96
Rate for Payer: United Healthcare Medicaid	$35,369.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,369.76

Other injury, poisoning & toxic effect diagnoses

Facility

$38,371.03

Service Code	APR-DRG 8151
Min. Negotiated Rate	$4,459.00
Max. Negotiated Rate	$38,371.03
Rate for Payer: Affinity Essential Plan 1&2	$38,371.03
Rate for Payer: Affinity Essential Plan 3&4	$38,371.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$17,053.79
Rate for Payer: Amida Care Medicaid	$17,053.79
Rate for Payer: EmblemHealth Essential Plan 1&2	$38,371.03
Rate for Payer: EmblemHealth Essential Plan 3&4	$17,053.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,053.79
Rate for Payer: Fidelis Qualified Health Plan	$20,464.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,053.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,053.79
Rate for Payer: Healthfirst Commercial	$7,629.00
Rate for Payer: Healthfirst Essential Plan	$38,371.03
Rate for Payer: Healthfirst QHP	$4,459.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,053.79
Rate for Payer: SOMOS Essential	$38,371.03
Rate for Payer: United Healthcare Essential Plan 1&2	$38,371.03
Rate for Payer: United Healthcare Essential Plan 3&4	$38,371.03
Rate for Payer: United Healthcare Medicaid	$17,053.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,053.79

Other injury, poisoning & toxic effect diagnoses

Facility

$50,564.41

Service Code	APR-DRG 8153
Min. Negotiated Rate	$11,550.00
Max. Negotiated Rate	$50,564.41
Rate for Payer: Affinity Essential Plan 1&2	$50,564.41
Rate for Payer: Affinity Essential Plan 3&4	$50,564.41
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,473.07
Rate for Payer: Amida Care Medicaid	$22,473.07
Rate for Payer: EmblemHealth Essential Plan 1&2	$50,564.41
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,473.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,473.07
Rate for Payer: Fidelis Qualified Health Plan	$26,967.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,473.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,473.07
Rate for Payer: Healthfirst Commercial	$19,420.00
Rate for Payer: Healthfirst Essential Plan	$50,564.41
Rate for Payer: Healthfirst QHP	$11,550.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,473.07
Rate for Payer: SOMOS Essential	$50,564.41
Rate for Payer: United Healthcare Essential Plan 1&2	$50,564.41
Rate for Payer: United Healthcare Essential Plan 3&4	$50,564.41
Rate for Payer: United Healthcare Medicaid	$22,473.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,473.07

OTHER INTRA-ABDOMINAL AND INTRAPERITONEAL SURGICAL PROCEDURES

Facility

$2,626.73

Service Code	EAPG 00108
Min. Negotiated Rate	$2,626.73
Max. Negotiated Rate	$2,626.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,626.73

OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS

Facility

$233.02

Service Code	EAPG 00726
Min. Negotiated Rate	$168.94
Max. Negotiated Rate	$233.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$168.94
Rate for Payer: Healthfirst Commercial	$233.02

Other kidney & urinary tract diagnoses, signs & symptoms

Facility

$52,935.19

Service Code	APR-DRG 4683
Min. Negotiated Rate	$11,777.00
Max. Negotiated Rate	$52,935.19
Rate for Payer: Affinity Essential Plan 1&2	$52,935.19
Rate for Payer: Affinity Essential Plan 3&4	$52,935.19
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,526.75
Rate for Payer: Amida Care Medicaid	$23,526.75
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,935.19
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,526.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,526.75
Rate for Payer: Fidelis Qualified Health Plan	$28,232.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,526.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,526.75
Rate for Payer: Healthfirst Commercial	$20,343.00
Rate for Payer: Healthfirst Essential Plan	$52,935.19
Rate for Payer: Healthfirst QHP	$11,777.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,526.75
Rate for Payer: SOMOS Essential	$52,935.19
Rate for Payer: United Healthcare Essential Plan 1&2	$52,935.19
Rate for Payer: United Healthcare Essential Plan 3&4	$52,935.19
Rate for Payer: United Healthcare Medicaid	$23,526.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,526.75

Other kidney & urinary tract diagnoses, signs & symptoms

Facility

$40,873.70

Service Code	APR-DRG 4681
Min. Negotiated Rate	$5,676.00
Max. Negotiated Rate	$40,873.70
Rate for Payer: Affinity Essential Plan 1&2	$40,873.70
Rate for Payer: Affinity Essential Plan 3&4	$40,873.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,166.09
Rate for Payer: Amida Care Medicaid	$18,166.09
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,873.70
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,166.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,166.09
Rate for Payer: Fidelis Qualified Health Plan	$21,799.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,166.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,166.09
Rate for Payer: Healthfirst Commercial	$10,158.00
Rate for Payer: Healthfirst Essential Plan	$40,873.70
Rate for Payer: Healthfirst QHP	$5,676.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,166.09
Rate for Payer: SOMOS Essential	$40,873.70
Rate for Payer: United Healthcare Essential Plan 1&2	$40,873.70
Rate for Payer: United Healthcare Essential Plan 3&4	$40,873.70
Rate for Payer: United Healthcare Medicaid	$18,166.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,166.09

Other kidney & urinary tract diagnoses, signs & symptoms

Facility

$44,800.99

Service Code	APR-DRG 4682
Min. Negotiated Rate	$8,117.00
Max. Negotiated Rate	$44,800.99
Rate for Payer: Affinity Essential Plan 1&2	$44,800.99
Rate for Payer: Affinity Essential Plan 3&4	$44,800.99
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,911.55
Rate for Payer: Amida Care Medicaid	$19,911.55
Rate for Payer: EmblemHealth Essential Plan 1&2	$44,800.99
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,911.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,911.55
Rate for Payer: Fidelis Qualified Health Plan	$23,893.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,911.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,911.55
Rate for Payer: Healthfirst Commercial	$13,449.00
Rate for Payer: Healthfirst Essential Plan	$44,800.99
Rate for Payer: Healthfirst QHP	$8,117.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,911.55
Rate for Payer: SOMOS Essential	$44,800.99
Rate for Payer: United Healthcare Essential Plan 1&2	$44,800.99
Rate for Payer: United Healthcare Essential Plan 3&4	$44,800.99
Rate for Payer: United Healthcare Medicaid	$19,911.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,911.55

Other kidney & urinary tract diagnoses, signs & symptoms

Facility

$81,414.56

Service Code	APR-DRG 4684
Min. Negotiated Rate	$28,399.00
Max. Negotiated Rate	$81,414.56
Rate for Payer: Affinity Essential Plan 1&2	$81,414.56
Rate for Payer: Affinity Essential Plan 3&4	$81,414.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$36,184.25
Rate for Payer: Amida Care Medicaid	$36,184.25
Rate for Payer: EmblemHealth Essential Plan 1&2	$81,414.56
Rate for Payer: EmblemHealth Essential Plan 3&4	$36,184.25
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,184.25
Rate for Payer: Fidelis Qualified Health Plan	$43,421.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,184.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,184.25
Rate for Payer: Healthfirst Commercial	$45,368.00
Rate for Payer: Healthfirst Essential Plan	$81,414.56
Rate for Payer: Healthfirst QHP	$28,399.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,184.25
Rate for Payer: SOMOS Essential	$81,414.56
Rate for Payer: United Healthcare Essential Plan 1&2	$81,414.56
Rate for Payer: United Healthcare Essential Plan 3&4	$81,414.56
Rate for Payer: United Healthcare Medicaid	$36,184.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,184.25

Other kidney, urinary tract & related procedures

Facility

$53,063.60

Service Code	APR-DRG 4471
Min. Negotiated Rate	$13,171.00
Max. Negotiated Rate	$53,063.60
Rate for Payer: Affinity Essential Plan 1&2	$53,063.60
Rate for Payer: Affinity Essential Plan 3&4	$53,063.60
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,583.82
Rate for Payer: Amida Care Medicaid	$23,583.82
Rate for Payer: EmblemHealth Essential Plan 1&2	$53,063.60
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,583.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,583.82
Rate for Payer: Fidelis Qualified Health Plan	$28,300.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,583.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,583.82
Rate for Payer: Healthfirst Commercial	$21,777.00
Rate for Payer: Healthfirst Essential Plan	$53,063.60
Rate for Payer: Healthfirst QHP	$13,171.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,583.82
Rate for Payer: SOMOS Essential	$53,063.60
Rate for Payer: United Healthcare Essential Plan 1&2	$53,063.60
Rate for Payer: United Healthcare Essential Plan 3&4	$53,063.60
Rate for Payer: United Healthcare Medicaid	$23,583.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,583.82

Other kidney, urinary tract & related procedures

Facility

$166,219.56

Service Code	APR-DRG 4474
Min. Negotiated Rate	$73,875.36
Max. Negotiated Rate	$166,219.56
Rate for Payer: Affinity Essential Plan 1&2	$166,219.56
Rate for Payer: Affinity Essential Plan 3&4	$166,219.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$73,875.36
Rate for Payer: Amida Care Medicaid	$73,875.36
Rate for Payer: EmblemHealth Essential Plan 1&2	$166,219.56
Rate for Payer: EmblemHealth Essential Plan 3&4	$73,875.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$73,875.36
Rate for Payer: Fidelis Qualified Health Plan	$88,650.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$73,875.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73,875.36
Rate for Payer: Healthfirst Commercial	$123,417.00
Rate for Payer: Healthfirst Essential Plan	$166,219.56
Rate for Payer: Healthfirst QHP	$76,315.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73,875.36
Rate for Payer: SOMOS Essential	$166,219.56
Rate for Payer: United Healthcare Essential Plan 1&2	$166,219.56
Rate for Payer: United Healthcare Essential Plan 3&4	$166,219.56
Rate for Payer: United Healthcare Medicaid	$73,875.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$73,875.36

Other kidney, urinary tract & related procedures

Facility

$54,922.57

Service Code	APR-DRG 4472
Min. Negotiated Rate	$16,343.00
Max. Negotiated Rate	$54,922.57
Rate for Payer: Affinity Essential Plan 1&2	$54,922.57
Rate for Payer: Affinity Essential Plan 3&4	$54,922.57
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,410.03
Rate for Payer: Amida Care Medicaid	$24,410.03
Rate for Payer: EmblemHealth Essential Plan 1&2	$54,922.57
Rate for Payer: EmblemHealth Essential Plan 3&4	$24,410.03
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,410.03
Rate for Payer: Fidelis Qualified Health Plan	$29,292.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,410.03
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,410.03
Rate for Payer: Healthfirst Commercial	$26,836.00
Rate for Payer: Healthfirst Essential Plan	$54,922.57
Rate for Payer: Healthfirst QHP	$16,343.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,410.03
Rate for Payer: SOMOS Essential	$54,922.57
Rate for Payer: United Healthcare Essential Plan 1&2	$54,922.57
Rate for Payer: United Healthcare Essential Plan 3&4	$54,922.57
Rate for Payer: United Healthcare Medicaid	$24,410.03
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,410.03

Other kidney, urinary tract & related procedures

Facility

$83,569.03

Service Code	APR-DRG 4473
Min. Negotiated Rate	$27,966.00
Max. Negotiated Rate	$83,569.03
Rate for Payer: Affinity Essential Plan 1&2	$83,569.03
Rate for Payer: Affinity Essential Plan 3&4	$83,569.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$37,141.79
Rate for Payer: Amida Care Medicaid	$37,141.79
Rate for Payer: EmblemHealth Essential Plan 1&2	$83,569.03
Rate for Payer: EmblemHealth Essential Plan 3&4	$37,141.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$37,141.79
Rate for Payer: Fidelis Qualified Health Plan	$44,570.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$37,141.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37,141.79
Rate for Payer: Healthfirst Commercial	$52,989.00
Rate for Payer: Healthfirst Essential Plan	$83,569.03
Rate for Payer: Healthfirst QHP	$27,966.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37,141.79
Rate for Payer: SOMOS Essential	$83,569.03
Rate for Payer: United Healthcare Essential Plan 1&2	$83,569.03
Rate for Payer: United Healthcare Essential Plan 3&4	$83,569.03
Rate for Payer: United Healthcare Medicaid	$37,141.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37,141.79

Other major head & neck procedures

Facility

$82,123.36

Service Code	APR-DRG 0912
Min. Negotiated Rate	$36,499.27
Max. Negotiated Rate	$82,123.36
Rate for Payer: Affinity Essential Plan 1&2	$82,123.36
Rate for Payer: Affinity Essential Plan 3&4	$82,123.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$36,499.27
Rate for Payer: Amida Care Medicaid	$36,499.27
Rate for Payer: EmblemHealth Essential Plan 1&2	$82,123.36
Rate for Payer: EmblemHealth Essential Plan 3&4	$36,499.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$36,499.27
Rate for Payer: Fidelis Qualified Health Plan	$43,799.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,499.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36,499.27
Rate for Payer: Healthfirst Commercial	$56,212.00
Rate for Payer: Healthfirst Essential Plan	$82,123.36
Rate for Payer: Healthfirst QHP	$48,034.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36,499.27
Rate for Payer: SOMOS Essential	$82,123.36
Rate for Payer: United Healthcare Essential Plan 1&2	$82,123.36
Rate for Payer: United Healthcare Essential Plan 3&4	$82,123.36
Rate for Payer: United Healthcare Medicaid	$36,499.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$36,499.27

Other major head & neck procedures

Facility

$104,876.26

Service Code	APR-DRG 0914
Min. Negotiated Rate	$46,611.67
Max. Negotiated Rate	$104,876.26
Rate for Payer: Affinity Essential Plan 1&2	$104,876.26
Rate for Payer: Affinity Essential Plan 3&4	$104,876.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$46,611.67
Rate for Payer: Amida Care Medicaid	$46,611.67
Rate for Payer: EmblemHealth Essential Plan 1&2	$104,876.26
Rate for Payer: EmblemHealth Essential Plan 3&4	$46,611.67
Rate for Payer: Fidelis CHP/HARP/Medicaid	$46,611.67
Rate for Payer: Fidelis Qualified Health Plan	$55,934.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$46,611.67
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$46,611.67
Rate for Payer: Healthfirst Commercial	$85,295.00
Rate for Payer: Healthfirst Essential Plan	$104,876.26
Rate for Payer: Healthfirst QHP	$48,038.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$46,611.67
Rate for Payer: SOMOS Essential	$104,876.26
Rate for Payer: United Healthcare Essential Plan 1&2	$104,876.26
Rate for Payer: United Healthcare Essential Plan 3&4	$104,876.26
Rate for Payer: United Healthcare Medicaid	$46,611.67
Rate for Payer: Wellcare CHP/FHP/Medicaid	$46,611.67

Other major head & neck procedures

Facility

$96,819.43

Service Code	APR-DRG 0913
Min. Negotiated Rate	$43,030.86
Max. Negotiated Rate	$96,819.43
Rate for Payer: Affinity Essential Plan 1&2	$96,819.43
Rate for Payer: Affinity Essential Plan 3&4	$96,819.43
Rate for Payer: Affinity Medicaid/CHP/HARP	$43,030.86
Rate for Payer: Amida Care Medicaid	$43,030.86
Rate for Payer: EmblemHealth Essential Plan 1&2	$96,819.43
Rate for Payer: EmblemHealth Essential Plan 3&4	$43,030.86
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43,030.86
Rate for Payer: Fidelis Qualified Health Plan	$51,637.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$43,030.86
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$43,030.86
Rate for Payer: Healthfirst Commercial	$77,896.00
Rate for Payer: Healthfirst Essential Plan	$96,819.43
Rate for Payer: Healthfirst QHP	$48,038.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43,030.86
Rate for Payer: SOMOS Essential	$96,819.43
Rate for Payer: United Healthcare Essential Plan 1&2	$96,819.43
Rate for Payer: United Healthcare Essential Plan 3&4	$96,819.43
Rate for Payer: United Healthcare Medicaid	$43,030.86
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43,030.86

Other major head & neck procedures

Facility

$55,488.89

Service Code	APR-DRG 0911
Min. Negotiated Rate	$15,619.00
Max. Negotiated Rate	$55,488.89
Rate for Payer: Affinity Essential Plan 1&2	$55,488.89
Rate for Payer: Affinity Essential Plan 3&4	$55,488.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$24,661.73
Rate for Payer: Amida Care Medicaid	$24,661.73
Rate for Payer: EmblemHealth Essential Plan 1&2	$55,488.89
Rate for Payer: EmblemHealth Essential Plan 3&4	$24,661.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24,661.73
Rate for Payer: Fidelis Qualified Health Plan	$29,594.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,661.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24,661.73
Rate for Payer: Healthfirst Commercial	$26,055.00
Rate for Payer: Healthfirst Essential Plan	$55,488.89
Rate for Payer: Healthfirst QHP	$15,619.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24,661.73
Rate for Payer: SOMOS Essential	$55,488.89
Rate for Payer: United Healthcare Essential Plan 1&2	$55,488.89
Rate for Payer: United Healthcare Essential Plan 3&4	$55,488.89
Rate for Payer: United Healthcare Medicaid	$24,661.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24,661.73

Know your out-of-pocket cost for care.

All Charges