St. Barnabas Hospital

All Charges

Charge

Type

Price

APR-DRG 0491: Bacterial & tuberculous infections of nervous system

Facility IP

$50,128.99

Service Code	APR-DRG 0491
Min. Negotiated Rate	$14,939.00
Max. Negotiated Rate	$50,128.99
Rate for Payer: Amida Care Medicaid	$22,279.55
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22,279.55
Rate for Payer: Fidelis Qualified Health Plan	$26,735.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,279.55
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$22,279.55
Rate for Payer: Healthfirst Commercial	$24,428.00
Rate for Payer: Healthfirst Essential Plan	$50,128.99
Rate for Payer: Healthfirst QHP	$14,939.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22,279.55
Rate for Payer: SOMOS Essential	$50,128.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$22,279.55

APR-DRG 0492: Bacterial & tuberculous infections of nervous system

Facility IP

$73,420.06

Service Code	APR-DRG 0492
Min. Negotiated Rate	$24,659.00
Max. Negotiated Rate	$73,420.06
Rate for Payer: Amida Care Medicaid	$32,631.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32,631.14
Rate for Payer: Fidelis Qualified Health Plan	$39,157.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$32,631.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$32,631.14
Rate for Payer: Healthfirst Commercial	$43,046.00
Rate for Payer: Healthfirst Essential Plan	$73,420.06
Rate for Payer: Healthfirst QHP	$24,659.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32,631.14
Rate for Payer: SOMOS Essential	$73,420.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$32,631.14

APR-DRG 0493: Bacterial & tuberculous infections of nervous system

Facility IP

$85,931.80

Service Code	APR-DRG 0493
Min. Negotiated Rate	$31,358.00
Max. Negotiated Rate	$85,931.80
Rate for Payer: Amida Care Medicaid	$38,191.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$38,191.91
Rate for Payer: Fidelis Qualified Health Plan	$45,830.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$38,191.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38,191.91
Rate for Payer: Healthfirst Commercial	$57,619.00
Rate for Payer: Healthfirst Essential Plan	$85,931.80
Rate for Payer: Healthfirst QHP	$31,358.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,191.91
Rate for Payer: SOMOS Essential	$85,931.80
Rate for Payer: Wellcare CHP/FHP/Medicaid	$38,191.91

APR-DRG 0494: Bacterial & tuberculous infections of nervous system

Facility IP

$134,596.30

Service Code	APR-DRG 0494
Min. Negotiated Rate	$53,770.00
Max. Negotiated Rate	$134,596.30
Rate for Payer: Amida Care Medicaid	$59,820.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59,820.58
Rate for Payer: Fidelis Qualified Health Plan	$71,784.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$59,820.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$59,820.58
Rate for Payer: Healthfirst Commercial	$88,637.00
Rate for Payer: Healthfirst Essential Plan	$134,596.30
Rate for Payer: Healthfirst QHP	$53,770.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59,820.58
Rate for Payer: SOMOS Essential	$134,596.30
Rate for Payer: Wellcare CHP/FHP/Medicaid	$59,820.58

APR-DRG 0501: Non-bacterial infections of nervous system exc viral meningitis

Facility IP

$42,842.52

Service Code	APR-DRG 0501
Min. Negotiated Rate	$8,912.00
Max. Negotiated Rate	$42,842.52
Rate for Payer: Amida Care Medicaid	$19,041.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,041.12
Rate for Payer: Fidelis Qualified Health Plan	$22,849.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,041.12
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,041.12
Rate for Payer: Healthfirst Commercial	$14,487.00
Rate for Payer: Healthfirst Essential Plan	$42,842.52
Rate for Payer: Healthfirst QHP	$8,912.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,041.12
Rate for Payer: SOMOS Essential	$42,842.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,041.12

APR-DRG 0502: Non-bacterial infections of nervous system exc viral meningitis

Facility IP

$53,430.16

Service Code	APR-DRG 0502
Min. Negotiated Rate	$11,929.00
Max. Negotiated Rate	$53,430.16
Rate for Payer: Amida Care Medicaid	$23,746.74
Rate for Payer: Fidelis CHP/HARP/Medicaid	$23,746.74
Rate for Payer: Fidelis Qualified Health Plan	$28,496.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,746.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$23,746.74
Rate for Payer: Healthfirst Commercial	$20,949.00
Rate for Payer: Healthfirst Essential Plan	$53,430.16
Rate for Payer: Healthfirst QHP	$11,929.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23,746.74
Rate for Payer: SOMOS Essential	$53,430.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$23,746.74

APR-DRG 0503: Non-bacterial infections of nervous system exc viral meningitis

Facility IP

$68,416.45

Service Code	APR-DRG 0503
Min. Negotiated Rate	$21,369.00
Max. Negotiated Rate	$68,416.45
Rate for Payer: Amida Care Medicaid	$30,407.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$30,407.31
Rate for Payer: Fidelis Qualified Health Plan	$36,488.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$30,407.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30,407.31
Rate for Payer: Healthfirst Commercial	$33,785.00
Rate for Payer: Healthfirst Essential Plan	$68,416.45
Rate for Payer: Healthfirst QHP	$21,369.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30,407.31
Rate for Payer: SOMOS Essential	$68,416.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30,407.31

APR-DRG 0504: Non-bacterial infections of nervous system exc viral meningitis

Facility IP

$123,674.49

Service Code	APR-DRG 0504
Min. Negotiated Rate	$47,280.00
Max. Negotiated Rate	$123,674.49
Rate for Payer: Amida Care Medicaid	$54,966.44
Rate for Payer: Fidelis CHP/HARP/Medicaid	$54,966.44
Rate for Payer: Fidelis Qualified Health Plan	$65,959.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$54,966.44
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54,966.44
Rate for Payer: Healthfirst Commercial	$84,048.00
Rate for Payer: Healthfirst Essential Plan	$123,674.49
Rate for Payer: Healthfirst QHP	$47,280.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54,966.44
Rate for Payer: SOMOS Essential	$123,674.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$54,966.44

APR-DRG 0511: Viral meningitis

Facility IP

$40,498.11

Service Code	APR-DRG 0511
Min. Negotiated Rate	$6,666.00
Max. Negotiated Rate	$40,498.11
Rate for Payer: Amida Care Medicaid	$17,999.16
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,999.16
Rate for Payer: Fidelis Qualified Health Plan	$21,598.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,999.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,999.16
Rate for Payer: Healthfirst Commercial	$11,794.00
Rate for Payer: Healthfirst Essential Plan	$40,498.11
Rate for Payer: Healthfirst QHP	$6,666.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,999.16
Rate for Payer: SOMOS Essential	$40,498.11
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,999.16

APR-DRG 0512: Viral meningitis

Facility IP

$43,417.62

Service Code	APR-DRG 0512
Min. Negotiated Rate	$8,569.00
Max. Negotiated Rate	$43,417.62
Rate for Payer: Amida Care Medicaid	$19,296.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,296.72
Rate for Payer: Fidelis Qualified Health Plan	$23,156.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,296.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,296.72
Rate for Payer: Healthfirst Commercial	$14,421.00
Rate for Payer: Healthfirst Essential Plan	$43,417.62
Rate for Payer: Healthfirst QHP	$8,569.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,296.72
Rate for Payer: SOMOS Essential	$43,417.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,296.72

APR-DRG 0513: Viral meningitis

Facility IP

$56,319.77

Service Code	APR-DRG 0513
Min. Negotiated Rate	$13,185.00
Max. Negotiated Rate	$56,319.77
Rate for Payer: Amida Care Medicaid	$25,031.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$25,031.01
Rate for Payer: Fidelis Qualified Health Plan	$30,037.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$25,031.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$25,031.01
Rate for Payer: Healthfirst Commercial	$23,767.00
Rate for Payer: Healthfirst Essential Plan	$56,319.77
Rate for Payer: Healthfirst QHP	$13,185.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25,031.01
Rate for Payer: SOMOS Essential	$56,319.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25,031.01

APR-DRG 0514: Viral meningitis

Facility IP

$60,085.26

Service Code	APR-DRG 0514
Min. Negotiated Rate	$26,704.56
Max. Negotiated Rate	$60,085.26
Rate for Payer: Amida Care Medicaid	$26,704.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26,704.56
Rate for Payer: Fidelis Qualified Health Plan	$32,045.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$26,704.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26,704.56
Rate for Payer: Healthfirst Commercial	$26,919.00
Rate for Payer: Healthfirst Essential Plan	$60,085.26
Rate for Payer: Healthfirst QHP	$38,705.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26,704.56
Rate for Payer: SOMOS Essential	$60,085.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26,704.56

APR-DRG 0521: Nontraumatic stupor & coma

Facility IP

$9,819.00

Service Code	APR-DRG 0521
Min. Negotiated Rate	$2,192.96
Max. Negotiated Rate	$9,819.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,192.96
Rate for Payer: Fidelis Qualified Health Plan	$2,631.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,192.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,192.96
Rate for Payer: Healthfirst Commercial	$9,819.00
Rate for Payer: Healthfirst Essential Plan	$4,934.16
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,192.96
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,934.16
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,934.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,192.96
Rate for Payer: SOMOS Essential	$4,934.16

APR-DRG 0522: Nontraumatic stupor & coma

Facility IP

$13,343.00

Service Code	APR-DRG 0522
Min. Negotiated Rate	$2,192.96
Max. Negotiated Rate	$13,343.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,192.96
Rate for Payer: Fidelis Qualified Health Plan	$2,631.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,192.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,192.96
Rate for Payer: Healthfirst Commercial	$13,343.00
Rate for Payer: Healthfirst Essential Plan	$4,934.16
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,192.96
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,934.16
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,934.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,192.96
Rate for Payer: SOMOS Essential	$4,934.16

APR-DRG 0523: Nontraumatic stupor & coma

Facility IP

$18,997.00

Service Code	APR-DRG 0523
Min. Negotiated Rate	$2,192.96
Max. Negotiated Rate	$18,997.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,192.96
Rate for Payer: Fidelis Qualified Health Plan	$2,631.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,192.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,192.96
Rate for Payer: Healthfirst Commercial	$18,997.00
Rate for Payer: Healthfirst Essential Plan	$4,934.16
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,192.96
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,934.16
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,934.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,192.96
Rate for Payer: SOMOS Essential	$4,934.16

APR-DRG 0524: Nontraumatic stupor & coma

Facility IP

$36,472.00

Service Code	APR-DRG 0524
Min. Negotiated Rate	$2,192.96
Max. Negotiated Rate	$36,472.00
Rate for Payer: Carelon Behavioral Health HARP/QHP	$2,192.96
Rate for Payer: Fidelis Qualified Health Plan	$2,631.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,192.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,192.96
Rate for Payer: Healthfirst Commercial	$36,472.00
Rate for Payer: Healthfirst Essential Plan	$4,934.16
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$2,192.96
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$4,934.16
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$4,934.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,192.96
Rate for Payer: SOMOS Essential	$4,934.16

APR-DRG 0531: Seizure

Facility IP

$38,225.81

Service Code	APR-DRG 0531
Min. Negotiated Rate	$5,622.00
Max. Negotiated Rate	$38,225.81
Rate for Payer: Amida Care Medicaid	$16,989.25
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16,989.25
Rate for Payer: Fidelis Qualified Health Plan	$20,387.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,989.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$16,989.25
Rate for Payer: Healthfirst Commercial	$9,338.00
Rate for Payer: Healthfirst Essential Plan	$38,225.81
Rate for Payer: Healthfirst QHP	$5,622.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,989.25
Rate for Payer: SOMOS Essential	$38,225.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,989.25

APR-DRG 0532: Seizure

Facility IP

$39,880.78

Service Code	APR-DRG 0532
Min. Negotiated Rate	$6,679.00
Max. Negotiated Rate	$39,880.78
Rate for Payer: Amida Care Medicaid	$17,724.79
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,724.79
Rate for Payer: Fidelis Qualified Health Plan	$21,269.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,724.79
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,724.79
Rate for Payer: Healthfirst Commercial	$11,081.00
Rate for Payer: Healthfirst Essential Plan	$39,880.78
Rate for Payer: Healthfirst QHP	$6,679.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,724.79
Rate for Payer: SOMOS Essential	$39,880.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,724.79

APR-DRG 0533: Seizure

Facility IP

$44,063.08

Service Code	APR-DRG 0533
Min. Negotiated Rate	$9,513.00
Max. Negotiated Rate	$44,063.08
Rate for Payer: Amida Care Medicaid	$19,583.59
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,583.59
Rate for Payer: Fidelis Qualified Health Plan	$23,500.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,583.59
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,583.59
Rate for Payer: Healthfirst Commercial	$16,550.00
Rate for Payer: Healthfirst Essential Plan	$44,063.08
Rate for Payer: Healthfirst QHP	$9,513.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,583.59
Rate for Payer: SOMOS Essential	$44,063.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,583.59

APR-DRG 0534: Seizure

Facility IP

$76,723.00

Service Code	APR-DRG 0534
Min. Negotiated Rate	$26,686.00
Max. Negotiated Rate	$76,723.00
Rate for Payer: Amida Care Medicaid	$34,099.11
Rate for Payer: Fidelis CHP/HARP/Medicaid	$34,099.11
Rate for Payer: Fidelis Qualified Health Plan	$40,918.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$34,099.11
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34,099.11
Rate for Payer: Healthfirst Commercial	$46,105.00
Rate for Payer: Healthfirst Essential Plan	$76,723.00
Rate for Payer: Healthfirst QHP	$26,686.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34,099.11
Rate for Payer: SOMOS Essential	$76,723.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34,099.11

APR-DRG 0541: Migraine & other headaches

Facility IP

$38,297.90

Service Code	APR-DRG 0541
Min. Negotiated Rate	$5,685.00
Max. Negotiated Rate	$38,297.90
Rate for Payer: Amida Care Medicaid	$17,021.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,021.29
Rate for Payer: Fidelis Qualified Health Plan	$20,425.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,021.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,021.29
Rate for Payer: Healthfirst Commercial	$9,464.00
Rate for Payer: Healthfirst Essential Plan	$38,297.90
Rate for Payer: Healthfirst QHP	$5,685.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,021.29
Rate for Payer: SOMOS Essential	$38,297.90
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,021.29

APR-DRG 0542: Migraine & other headaches

Facility IP

$40,410.16

Service Code	APR-DRG 0542
Min. Negotiated Rate	$6,674.00
Max. Negotiated Rate	$40,410.16
Rate for Payer: Amida Care Medicaid	$17,960.07
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,960.07
Rate for Payer: Fidelis Qualified Health Plan	$21,552.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,960.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,960.07
Rate for Payer: Healthfirst Commercial	$11,114.00
Rate for Payer: Healthfirst Essential Plan	$40,410.16
Rate for Payer: Healthfirst QHP	$6,674.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,960.07
Rate for Payer: SOMOS Essential	$40,410.16
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,960.07

APR-DRG 0543: Migraine & other headaches

Facility IP

$43,535.45

Service Code	APR-DRG 0543
Min. Negotiated Rate	$8,224.00
Max. Negotiated Rate	$43,535.45
Rate for Payer: Amida Care Medicaid	$19,349.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,349.09
Rate for Payer: Fidelis Qualified Health Plan	$23,218.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,349.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,349.09
Rate for Payer: Healthfirst Commercial	$14,219.00
Rate for Payer: Healthfirst Essential Plan	$43,535.45
Rate for Payer: Healthfirst QHP	$8,224.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,349.09
Rate for Payer: SOMOS Essential	$43,535.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,349.09

APR-DRG 0544: Migraine & other headaches

Facility IP

$43,790.47

Service Code	APR-DRG 0544
Min. Negotiated Rate	$14,363.00
Max. Negotiated Rate	$43,790.47
Rate for Payer: Amida Care Medicaid	$19,462.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$19,462.43
Rate for Payer: Fidelis Qualified Health Plan	$23,354.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,462.43
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$19,462.43
Rate for Payer: Healthfirst Commercial	$14,363.00
Rate for Payer: Healthfirst Essential Plan	$43,790.47
Rate for Payer: Healthfirst QHP	$15,536.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$19,462.43
Rate for Payer: SOMOS Essential	$43,790.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19,462.43

APR-DRG 0551: Head trauma w coma >1 hr or hemorrhage

Facility IP

$39,437.57

Service Code	APR-DRG 0551
Min. Negotiated Rate	$6,822.00
Max. Negotiated Rate	$39,437.57
Rate for Payer: Amida Care Medicaid	$17,527.81
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17,527.81
Rate for Payer: Fidelis Qualified Health Plan	$21,033.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,527.81
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$17,527.81
Rate for Payer: Healthfirst Commercial	$11,046.00
Rate for Payer: Healthfirst Essential Plan	$39,437.57
Rate for Payer: Healthfirst QHP	$6,822.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17,527.81
Rate for Payer: SOMOS Essential	$39,437.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17,527.81

Price Transparency.

All Charges