St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OTHER MAJOR LIVER DIAGNOSES

Facility

$162.00

Service Code	EAPG 00641
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.00

OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES

Facility

$228.33

Service Code	EAPG 00741
Min. Negotiated Rate	$166.63
Max. Negotiated Rate	$228.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$166.63
Rate for Payer: Healthfirst Commercial	$228.33

Other male reproductive system & related procedures

Facility

$52,710.07

Service Code	APR-DRG 4842
Min. Negotiated Rate	$12,076.00
Max. Negotiated Rate	$52,710.07
Rate for Payer: Affinity Essential Plan 1&2	$52,710.07
Rate for Payer: Affinity Essential Plan 3&4	$52,710.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,426.70
Rate for Payer: Amida Care Medicaid	$23,426.70
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,710.07
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,426.70
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,426.70
Rate for Payer: Fidelis Qualified Health Plan	$28,112.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,426.70
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,426.70
Rate for Payer: Healthfirst Commercial	$22,059.00
Rate for Payer: Healthfirst Essential Plan	$52,710.07
Rate for Payer: Healthfirst QHP	$12,076.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,426.70
Rate for Payer: SOMOS Essential	$52,710.07
Rate for Payer: United Healthcare Essential Plan 1&2	$52,710.07
Rate for Payer: United Healthcare Essential Plan 3&4	$52,710.07
Rate for Payer: United Healthcare Medicaid	$23,426.70
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,426.70

Other male reproductive system & related procedures

Facility

$66,699.13

Service Code	APR-DRG 4843
Min. Negotiated Rate	$16,906.00
Max. Negotiated Rate	$66,699.13
Rate for Payer: Affinity Essential Plan 1&2	$66,699.13
Rate for Payer: Affinity Essential Plan 3&4	$66,699.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$29,644.06
Rate for Payer: Amida Care Medicaid	$29,644.06
Rate for Payer: EmblemHealth Essential Plan 1&2	$66,699.13
Rate for Payer: EmblemHealth Essential Plan 3&4	$29,644.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$29,644.06
Rate for Payer: Fidelis Qualified Health Plan	$35,572.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$29,644.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29,644.06
Rate for Payer: Healthfirst Commercial	$30,458.00
Rate for Payer: Healthfirst Essential Plan	$66,699.13
Rate for Payer: Healthfirst QHP	$16,906.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29,644.06
Rate for Payer: SOMOS Essential	$66,699.13
Rate for Payer: United Healthcare Essential Plan 1&2	$66,699.13
Rate for Payer: United Healthcare Essential Plan 3&4	$66,699.13
Rate for Payer: United Healthcare Medicaid	$29,644.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29,644.06

Other male reproductive system & related procedures

Facility

$47,465.50

Service Code	APR-DRG 4841
Min. Negotiated Rate	$8,303.00
Max. Negotiated Rate	$47,465.50
Rate for Payer: Affinity Essential Plan 1&2	$47,465.50
Rate for Payer: Affinity Essential Plan 3&4	$47,465.50
Rate for Payer: Affinity Medicaid/CHP/HARP	$21,095.78
Rate for Payer: Amida Care Medicaid	$21,095.78
Rate for Payer: EmblemHealth Essential Plan 1&2	$47,465.50
Rate for Payer: EmblemHealth Essential Plan 3&4	$21,095.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21,095.78
Rate for Payer: Fidelis Qualified Health Plan	$25,314.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$21,095.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$21,095.78
Rate for Payer: Healthfirst Commercial	$14,034.00
Rate for Payer: Healthfirst Essential Plan	$47,465.50
Rate for Payer: Healthfirst QHP	$8,303.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21,095.78
Rate for Payer: SOMOS Essential	$47,465.50
Rate for Payer: United Healthcare Essential Plan 1&2	$47,465.50
Rate for Payer: United Healthcare Essential Plan 3&4	$47,465.50
Rate for Payer: United Healthcare Medicaid	$21,095.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21,095.78

Other male reproductive system & related procedures

Facility

$69,792.77

Service Code	APR-DRG 4844
Min. Negotiated Rate	$19,543.00
Max. Negotiated Rate	$69,792.77
Rate for Payer: Affinity Essential Plan 1&2	$69,792.77
Rate for Payer: Affinity Essential Plan 3&4	$69,792.77
Rate for Payer: Affinity Medicaid/CHP/HARP	$31,019.01
Rate for Payer: Amida Care Medicaid	$31,019.01
Rate for Payer: EmblemHealth Essential Plan 1&2	$69,792.77
Rate for Payer: EmblemHealth Essential Plan 3&4	$31,019.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31,019.01
Rate for Payer: Fidelis Qualified Health Plan	$37,222.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$31,019.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31,019.01
Rate for Payer: Healthfirst Commercial	$31,526.00
Rate for Payer: Healthfirst Essential Plan	$69,792.77
Rate for Payer: Healthfirst QHP	$19,543.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31,019.01
Rate for Payer: SOMOS Essential	$69,792.77
Rate for Payer: United Healthcare Essential Plan 1&2	$69,792.77
Rate for Payer: United Healthcare Essential Plan 3&4	$69,792.77
Rate for Payer: United Healthcare Medicaid	$31,019.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31,019.01

Other mental health disorders

Facility

$12,018.00

Service Code	APR-DRG 7603
Min. Negotiated Rate	$3,331.32
Max. Negotiated Rate	$12,018.00
Rate for Payer: Affinity Essential Plan 1&2	$3,331.32
Rate for Payer: Affinity Essential Plan 3&4	$3,331.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,331.32
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,331.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,495.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,331.32
Rate for Payer: Fidelis Qualified Health Plan	$3,997.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,331.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,331.32
Rate for Payer: Healthfirst Commercial	$12,018.00
Rate for Payer: Healthfirst Essential Plan	$7,495.47
Rate for Payer: Healthfirst QHP	$6,063.00
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,331.32
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,495.47
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,495.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,331.32
Rate for Payer: SOMOS Essential	$7,495.47
Rate for Payer: United Healthcare Essential Plan 1&2	$7,495.47
Rate for Payer: United Healthcare Essential Plan 3&4	$7,495.47
Rate for Payer: United Healthcare Medicaid	$3,331.32

Other mental health disorders

Facility

$9,601.00

Service Code	APR-DRG 7601
Min. Negotiated Rate	$3,331.32
Max. Negotiated Rate	$9,601.00
Rate for Payer: Affinity Essential Plan 1&2	$3,331.32
Rate for Payer: Affinity Essential Plan 3&4	$3,331.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,331.32
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,331.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,495.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,331.32
Rate for Payer: Fidelis Qualified Health Plan	$3,997.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,331.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,331.32
Rate for Payer: Healthfirst Commercial	$9,601.00
Rate for Payer: Healthfirst Essential Plan	$7,495.47
Rate for Payer: Healthfirst QHP	$6,063.00
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,331.32
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,495.47
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,495.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,331.32
Rate for Payer: SOMOS Essential	$7,495.47
Rate for Payer: United Healthcare Essential Plan 1&2	$7,495.47
Rate for Payer: United Healthcare Essential Plan 3&4	$7,495.47
Rate for Payer: United Healthcare Medicaid	$3,331.32

Other mental health disorders

Facility

$10,888.00

Service Code	APR-DRG 7602
Min. Negotiated Rate	$3,331.32
Max. Negotiated Rate	$10,888.00
Rate for Payer: Affinity Essential Plan 1&2	$3,331.32
Rate for Payer: Affinity Essential Plan 3&4	$3,331.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,331.32
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,331.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,495.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,331.32
Rate for Payer: Fidelis Qualified Health Plan	$3,997.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,331.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,331.32
Rate for Payer: Healthfirst Commercial	$10,888.00
Rate for Payer: Healthfirst Essential Plan	$7,495.47
Rate for Payer: Healthfirst QHP	$6,063.00
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,331.32
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,495.47
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,495.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,331.32
Rate for Payer: SOMOS Essential	$7,495.47
Rate for Payer: United Healthcare Essential Plan 1&2	$7,495.47
Rate for Payer: United Healthcare Essential Plan 3&4	$7,495.47
Rate for Payer: United Healthcare Medicaid	$3,331.32

Other mental health disorders

Facility

$12,018.00

Service Code	APR-DRG 7604
Min. Negotiated Rate	$3,331.32
Max. Negotiated Rate	$12,018.00
Rate for Payer: Affinity Essential Plan 1&2	$3,331.32
Rate for Payer: Affinity Essential Plan 3&4	$3,331.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,331.32
Rate for Payer: Carelon Behavioral Health HARP/QHP	$3,331.32
Rate for Payer: EmblemHealth Essential Plan 1&2	$7,495.47
Rate for Payer: EmblemHealth Essential Plan 3&4	$3,331.32
Rate for Payer: Fidelis Qualified Health Plan	$3,997.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,331.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,331.32
Rate for Payer: Healthfirst Commercial	$12,018.00
Rate for Payer: Healthfirst Essential Plan	$7,495.47
Rate for Payer: Healthfirst QHP	$6,063.00
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$3,331.32
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$7,495.47
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$7,495.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,331.32
Rate for Payer: SOMOS Essential	$7,495.47
Rate for Payer: United Healthcare Essential Plan 1&2	$7,495.47
Rate for Payer: United Healthcare Essential Plan 3&4	$7,495.47
Rate for Payer: United Healthcare Medicaid	$3,331.32

OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES

Facility

$242.85

Service Code	EAPG 00660
Min. Negotiated Rate	$175.89
Max. Negotiated Rate	$242.85
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$175.89
Rate for Payer: Healthfirst Commercial	$242.85

Other musculoskeletal system & connective tissue diagnoses

Facility

$52,324.92

Service Code	APR-DRG 3513
Min. Negotiated Rate	$10,650.00
Max. Negotiated Rate	$52,324.92
Rate for Payer: Affinity Essential Plan 1&2	$52,324.92
Rate for Payer: Affinity Essential Plan 3&4	$52,324.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,255.52
Rate for Payer: Amida Care Medicaid	$23,255.52
Rate for Payer: EmblemHealth Essential Plan 1&2	$52,324.92
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,255.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,255.52
Rate for Payer: Fidelis Qualified Health Plan	$27,906.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,255.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,255.52
Rate for Payer: Healthfirst Commercial	$19,859.00
Rate for Payer: Healthfirst Essential Plan	$52,324.92
Rate for Payer: Healthfirst QHP	$10,650.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,255.52
Rate for Payer: SOMOS Essential	$52,324.92
Rate for Payer: United Healthcare Essential Plan 1&2	$52,324.92
Rate for Payer: United Healthcare Essential Plan 3&4	$52,324.92
Rate for Payer: United Healthcare Medicaid	$23,255.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,255.52

Other musculoskeletal system & connective tissue diagnoses

Facility

$40,650.35

Service Code	APR-DRG 3511
Min. Negotiated Rate	$5,540.00
Max. Negotiated Rate	$40,650.35
Rate for Payer: Affinity Essential Plan 1&2	$40,650.35
Rate for Payer: Affinity Essential Plan 3&4	$40,650.35
Rate for Payer: Affinity Medicaid/CHP/HARP	$18,066.82
Rate for Payer: Amida Care Medicaid	$18,066.82
Rate for Payer: EmblemHealth Essential Plan 1&2	$40,650.35
Rate for Payer: EmblemHealth Essential Plan 3&4	$18,066.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$18,066.82
Rate for Payer: Fidelis Qualified Health Plan	$21,680.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,066.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18,066.82
Rate for Payer: Healthfirst Commercial	$9,581.00
Rate for Payer: Healthfirst Essential Plan	$40,650.35
Rate for Payer: Healthfirst QHP	$5,540.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,066.82
Rate for Payer: SOMOS Essential	$40,650.35
Rate for Payer: United Healthcare Essential Plan 1&2	$40,650.35
Rate for Payer: United Healthcare Essential Plan 3&4	$40,650.35
Rate for Payer: United Healthcare Medicaid	$18,066.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$18,066.82

Other musculoskeletal system & connective tissue diagnoses

Facility

$43,251.55

Service Code	APR-DRG 3512
Min. Negotiated Rate	$7,041.00
Max. Negotiated Rate	$43,251.55
Rate for Payer: Affinity Essential Plan 1&2	$43,251.55
Rate for Payer: Affinity Essential Plan 3&4	$43,251.55
Rate for Payer: Affinity Medicaid/CHP/HARP	$19,222.91
Rate for Payer: Amida Care Medicaid	$19,222.91
Rate for Payer: EmblemHealth Essential Plan 1&2	$43,251.55
Rate for Payer: EmblemHealth Essential Plan 3&4	$19,222.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,222.91
Rate for Payer: Fidelis Qualified Health Plan	$23,067.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,222.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,222.91
Rate for Payer: Healthfirst Commercial	$12,035.00
Rate for Payer: Healthfirst Essential Plan	$43,251.55
Rate for Payer: Healthfirst QHP	$7,041.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,222.91
Rate for Payer: SOMOS Essential	$43,251.55
Rate for Payer: United Healthcare Essential Plan 1&2	$43,251.55
Rate for Payer: United Healthcare Essential Plan 3&4	$43,251.55
Rate for Payer: United Healthcare Medicaid	$19,222.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,222.91

Other musculoskeletal system & connective tissue diagnoses

Facility

$86,194.85

Service Code	APR-DRG 3514
Min. Negotiated Rate	$25,022.00
Max. Negotiated Rate	$86,194.85
Rate for Payer: Affinity Essential Plan 1&2	$86,194.85
Rate for Payer: Affinity Essential Plan 3&4	$86,194.85
Rate for Payer: Affinity Medicaid/CHP/HARP	$38,308.82
Rate for Payer: Amida Care Medicaid	$38,308.82
Rate for Payer: EmblemHealth Essential Plan 1&2	$86,194.85
Rate for Payer: EmblemHealth Essential Plan 3&4	$38,308.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$38,308.82
Rate for Payer: Fidelis Qualified Health Plan	$45,970.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$38,308.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38,308.82
Rate for Payer: Healthfirst Commercial	$48,157.00
Rate for Payer: Healthfirst Essential Plan	$86,194.85
Rate for Payer: Healthfirst QHP	$25,022.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,308.82
Rate for Payer: SOMOS Essential	$86,194.85
Rate for Payer: United Healthcare Essential Plan 1&2	$86,194.85
Rate for Payer: United Healthcare Essential Plan 3&4	$86,194.85
Rate for Payer: United Healthcare Medicaid	$38,308.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$38,308.82

Other musculoskeletal system & connective tissue procedures

Facility

$50,050.85

Service Code	APR-DRG 3201
Min. Negotiated Rate	$10,743.00
Max. Negotiated Rate	$50,050.85
Rate for Payer: Affinity Essential Plan 1&2	$50,050.85
Rate for Payer: Affinity Essential Plan 3&4	$50,050.85
Rate for Payer: Affinity Medicaid/CHP/HARP	$22,244.82
Rate for Payer: Amida Care Medicaid	$22,244.82
Rate for Payer: EmblemHealth Essential Plan 1&2	$50,050.85
Rate for Payer: EmblemHealth Essential Plan 3&4	$22,244.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,244.82
Rate for Payer: Fidelis Qualified Health Plan	$26,693.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,244.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,244.82
Rate for Payer: Healthfirst Commercial	$18,516.00
Rate for Payer: Healthfirst Essential Plan	$50,050.85
Rate for Payer: Healthfirst QHP	$10,743.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,244.82
Rate for Payer: SOMOS Essential	$50,050.85
Rate for Payer: United Healthcare Essential Plan 1&2	$50,050.85
Rate for Payer: United Healthcare Essential Plan 3&4	$50,050.85
Rate for Payer: United Healthcare Medicaid	$22,244.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,244.82

Other musculoskeletal system & connective tissue procedures

Facility

$60,645.53

Service Code	APR-DRG 3202
Min. Negotiated Rate	$17,953.00
Max. Negotiated Rate	$60,645.53
Rate for Payer: Affinity Essential Plan 1&2	$60,645.53
Rate for Payer: Affinity Essential Plan 3&4	$60,645.53
Rate for Payer: Affinity Medicaid/CHP/HARP	$26,953.57
Rate for Payer: Amida Care Medicaid	$26,953.57
Rate for Payer: EmblemHealth Essential Plan 1&2	$60,645.53
Rate for Payer: EmblemHealth Essential Plan 3&4	$26,953.57
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,953.57
Rate for Payer: Fidelis Qualified Health Plan	$32,344.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,953.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,953.57
Rate for Payer: Healthfirst Commercial	$30,130.00
Rate for Payer: Healthfirst Essential Plan	$60,645.53
Rate for Payer: Healthfirst QHP	$17,953.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,953.57
Rate for Payer: SOMOS Essential	$60,645.53
Rate for Payer: United Healthcare Essential Plan 1&2	$60,645.53
Rate for Payer: United Healthcare Essential Plan 3&4	$60,645.53
Rate for Payer: United Healthcare Medicaid	$26,953.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,953.57

Other musculoskeletal system & connective tissue procedures

Facility

$76,247.37

Service Code	APR-DRG 3203
Min. Negotiated Rate	$27,682.00
Max. Negotiated Rate	$76,247.37
Rate for Payer: Affinity Essential Plan 1&2	$76,247.37
Rate for Payer: Affinity Essential Plan 3&4	$76,247.37
Rate for Payer: Affinity Medicaid/CHP/HARP	$33,887.72
Rate for Payer: Amida Care Medicaid	$33,887.72
Rate for Payer: EmblemHealth Essential Plan 1&2	$76,247.37
Rate for Payer: EmblemHealth Essential Plan 3&4	$33,887.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33,887.72
Rate for Payer: Fidelis Qualified Health Plan	$40,665.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$33,887.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$33,887.72
Rate for Payer: Healthfirst Commercial	$47,919.00
Rate for Payer: Healthfirst Essential Plan	$76,247.37
Rate for Payer: Healthfirst QHP	$27,682.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33,887.72
Rate for Payer: SOMOS Essential	$76,247.37
Rate for Payer: United Healthcare Essential Plan 1&2	$76,247.37
Rate for Payer: United Healthcare Essential Plan 3&4	$76,247.37
Rate for Payer: United Healthcare Medicaid	$33,887.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33,887.72

Other musculoskeletal system & connective tissue procedures

Facility

$120,017.29

Service Code	APR-DRG 3204
Min. Negotiated Rate	$53,341.02
Max. Negotiated Rate	$120,017.29
Rate for Payer: Affinity Essential Plan 1&2	$120,017.29
Rate for Payer: Affinity Essential Plan 3&4	$120,017.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$53,341.02
Rate for Payer: Amida Care Medicaid	$53,341.02
Rate for Payer: EmblemHealth Essential Plan 1&2	$120,017.29
Rate for Payer: EmblemHealth Essential Plan 3&4	$53,341.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$53,341.02
Rate for Payer: Fidelis Qualified Health Plan	$64,009.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$53,341.02
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$53,341.02
Rate for Payer: Healthfirst Commercial	$107,294.00
Rate for Payer: Healthfirst Essential Plan	$120,017.29
Rate for Payer: Healthfirst QHP	$71,428.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$53,341.02
Rate for Payer: SOMOS Essential	$120,017.29
Rate for Payer: United Healthcare Essential Plan 1&2	$120,017.29
Rate for Payer: United Healthcare Essential Plan 3&4	$120,017.29
Rate for Payer: United Healthcare Medicaid	$53,341.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$53,341.02

Other nervous system & related procedures

Facility

$53,591.20

Service Code	APR-DRG 0261
Min. Negotiated Rate	$13,284.00
Max. Negotiated Rate	$53,591.20
Rate for Payer: Affinity Essential Plan 1&2	$53,591.20
Rate for Payer: Affinity Essential Plan 3&4	$53,591.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$23,818.31
Rate for Payer: Amida Care Medicaid	$23,818.31
Rate for Payer: EmblemHealth Essential Plan 1&2	$53,591.20
Rate for Payer: EmblemHealth Essential Plan 3&4	$23,818.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,818.31
Rate for Payer: Fidelis Qualified Health Plan	$28,581.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,818.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,818.31
Rate for Payer: Healthfirst Commercial	$22,179.00
Rate for Payer: Healthfirst Essential Plan	$53,591.20
Rate for Payer: Healthfirst QHP	$13,284.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,818.31
Rate for Payer: SOMOS Essential	$53,591.20
Rate for Payer: United Healthcare Essential Plan 1&2	$53,591.20
Rate for Payer: United Healthcare Essential Plan 3&4	$53,591.20
Rate for Payer: United Healthcare Medicaid	$23,818.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,818.31

Other nervous system & related procedures

Facility

$63,603.74

Service Code	APR-DRG 0262
Min. Negotiated Rate	$21,020.00
Max. Negotiated Rate	$63,603.74
Rate for Payer: Affinity Essential Plan 1&2	$63,603.74
Rate for Payer: Affinity Essential Plan 3&4	$63,603.74
Rate for Payer: Affinity Medicaid/CHP/HARP	$28,268.33
Rate for Payer: Amida Care Medicaid	$28,268.33
Rate for Payer: EmblemHealth Essential Plan 1&2	$63,603.74
Rate for Payer: EmblemHealth Essential Plan 3&4	$28,268.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$28,268.33
Rate for Payer: Fidelis Qualified Health Plan	$33,922.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$28,268.33
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28,268.33
Rate for Payer: Healthfirst Commercial	$31,589.00
Rate for Payer: Healthfirst Essential Plan	$63,603.74
Rate for Payer: Healthfirst QHP	$21,020.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$28,268.33
Rate for Payer: SOMOS Essential	$63,603.74
Rate for Payer: United Healthcare Essential Plan 1&2	$63,603.74
Rate for Payer: United Healthcare Essential Plan 3&4	$63,603.74
Rate for Payer: United Healthcare Medicaid	$28,268.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28,268.33

Other nervous system & related procedures

Facility

$78,947.05

Service Code	APR-DRG 0263
Min. Negotiated Rate	$31,417.00
Max. Negotiated Rate	$78,947.05
Rate for Payer: Affinity Essential Plan 1&2	$78,947.05
Rate for Payer: Affinity Essential Plan 3&4	$78,947.05
Rate for Payer: Affinity Medicaid/CHP/HARP	$35,087.58
Rate for Payer: Amida Care Medicaid	$35,087.58
Rate for Payer: EmblemHealth Essential Plan 1&2	$78,947.05
Rate for Payer: EmblemHealth Essential Plan 3&4	$35,087.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35,087.58
Rate for Payer: Fidelis Qualified Health Plan	$42,105.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$35,087.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35,087.58
Rate for Payer: Healthfirst Commercial	$54,323.00
Rate for Payer: Healthfirst Essential Plan	$78,947.05
Rate for Payer: Healthfirst QHP	$31,417.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35,087.58
Rate for Payer: SOMOS Essential	$78,947.05
Rate for Payer: United Healthcare Essential Plan 1&2	$78,947.05
Rate for Payer: United Healthcare Essential Plan 3&4	$78,947.05
Rate for Payer: United Healthcare Medicaid	$35,087.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$35,087.58

Other nervous system & related procedures

Facility

$142,393.82

Service Code	APR-DRG 0264
Min. Negotiated Rate	$63,286.14
Max. Negotiated Rate	$142,393.82
Rate for Payer: Affinity Essential Plan 1&2	$142,393.82
Rate for Payer: Affinity Essential Plan 3&4	$142,393.82
Rate for Payer: Affinity Medicaid/CHP/HARP	$63,286.14
Rate for Payer: Amida Care Medicaid	$63,286.14
Rate for Payer: EmblemHealth Essential Plan 1&2	$142,393.82
Rate for Payer: EmblemHealth Essential Plan 3&4	$63,286.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$63,286.14
Rate for Payer: Fidelis Qualified Health Plan	$75,943.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$63,286.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$63,286.14
Rate for Payer: Healthfirst Commercial	$115,574.00
Rate for Payer: Healthfirst Essential Plan	$142,393.82
Rate for Payer: Healthfirst QHP	$96,336.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$63,286.14
Rate for Payer: SOMOS Essential	$142,393.82
Rate for Payer: United Healthcare Essential Plan 1&2	$142,393.82
Rate for Payer: United Healthcare Essential Plan 3&4	$142,393.82
Rate for Payer: United Healthcare Medicaid	$63,286.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$63,286.14

OTHER OPHTHALMIC SYSTEM DIAGNOSES

Facility

$239.81

Service Code	EAPG 00553
Min. Negotiated Rate	$173.57
Max. Negotiated Rate	$239.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$173.57
Rate for Payer: Healthfirst Commercial	$239.81

Other O.R. procedures for lymphatic/hematopoietic/other neoplasms

Facility

$189,797.31

Service Code	APR-DRG 6814
Min. Negotiated Rate	$84,354.36
Max. Negotiated Rate	$189,797.31
Rate for Payer: Affinity Essential Plan 1&2	$189,797.31
Rate for Payer: Affinity Essential Plan 3&4	$189,797.31
Rate for Payer: Affinity Medicaid/CHP/HARP	$84,354.36
Rate for Payer: Amida Care Medicaid	$84,354.36
Rate for Payer: EmblemHealth Essential Plan 1&2	$189,797.31
Rate for Payer: EmblemHealth Essential Plan 3&4	$84,354.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$84,354.36
Rate for Payer: Fidelis Qualified Health Plan	$101,225.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$84,354.36
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$84,354.36
Rate for Payer: Healthfirst Commercial	$143,474.00
Rate for Payer: Healthfirst Essential Plan	$189,797.31
Rate for Payer: Healthfirst QHP	$93,926.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$84,354.36
Rate for Payer: SOMOS Essential	$189,797.31
Rate for Payer: United Healthcare Essential Plan 1&2	$189,797.31
Rate for Payer: United Healthcare Essential Plan 3&4	$189,797.31
Rate for Payer: United Healthcare Medicaid	$84,354.36
Rate for Payer: Wellcare CHP/FHP/Medicaid	$84,354.36

Know your out-of-pocket cost for care.

All Charges